The Effect Of Modified Constraint-induced Movement Therapy(mCIMT) And Hand-arm Bimanual Intensive Therapy(HABIT) In Children With Hemiplegic Cerebral Palsy

Objective: Analyse the effect of modified constraint-induced movement therapy(mCIMT)and hand-arm bimanual intensive therapy(HABIT)for improving fine function,amount of use and functional independence in children with hemiplegic cerebral palsy in order to understand the characteristics of mCIMT and HABIT and provide a basis for their clinical application.Methods: From February 2018 to October 2018,30 children with hemiplegic cerebral palsy from 3 to 6 years old admitted to the Third Affiliated Hospital of Jiamusi University were enrolled.They were randomized to mCIMT group(n=10),HABIT group(n=10)or control group(n=10)according to randomized table method,and received mCIMT,HABIT and conventional OT respectively for 8 weeks.Before and after treatment,the the Carroll Upper Extremities Functional Test,(UEFT),Peabody developmental motor scales-fine motor,(PDMS-FM),Functional Independence Measure Children’s Edition(WeeFIM),and Motor Activity Log-Amount of Use(MAL-AOU)),hand grip strength were evaluated.Results: After intervention,there were significant increase in the UEFT,PDMS-FM,WeeFIM,MAL-AOU scores and grip strength of mCIMT group,HABIT group and control group(all p<0.01).The comparison among the groups showed that the scores and grip strength of the children in the mCIMT group and the HABIT group were higher than those in the control group(all p<0.05).The scores of WeeFIM and MAL-AOU in the HABIT group were higher than those in the mCIMT group(p<0.05),and the grip strength in the mCIMT group was higher than that in the HABIT group(p<0.05).In addition,after 8-week treatment,the scores of UEFT,PDMS-FM,WeeFIM,MAL-AOU and hand grip strength in the mCIMT group and the HABIT group were significantly higher than those in the 4-week treatment(all p<0.01).Conclusion: mCIMT and HABIT can improve the functional status and functional independence of the upper limbs of children with hemiplegic cerebral palsy effectively,and the therapeutic effect is better than conventional OT.Compared with mCIMT,HABIT is more effective in improving the affected hand’s spontaneous use and functional independence in children with hemiplegic cerebral palsy.mCIMT is superior to HABIT in improving the grip strength of children with hemiplegic cerebral palsy.