Upper limb physical therapy interventions to improve functions in cerebral palsy children: A review article
Keywords:
Physical therapy, unilateral cerebral palsy, upper limb, functional outcomes, children, motor controlAbstract
Introduction: upper limb function is considered challenging barrier for children with cerebral palsy hindering their activity levels and participation in play activities at home, school or other contexts. The aim of this critical review is to gain a deeper understanding of how the different physical therapy interventions could be beneficial in terms of functional outcomes either when used separately or combined with each other’s and provide summary of dosing reported for each. Method: A literature search was conducted using electronic databases for health research; Embase, Cochrane, Pedro, Science Direct and Clinical Key. 16 papers where selected meeting the aim of the review and the criteria of work (randomized control trials. systematic reviews, meta-analysis) and critically reviewed. Findings: recommended dosing in literature was: for CIMT dosing 60 hours over 10 days and 6 hours per day for 15 days, for HABIT 6 hours per day for 15 days and 6 hours per day for 3 weeks, for Strength Training is 6-10 per set, and the intensity (load) is increased to 85% 1RM. While, goal directed training dosing to be effective should exceed 30-40 hours per week and Virtual reality to be more than 1080 minutes over 4 weeks.
Downloads
References
Rathinam C. , Vikram Mohan , Janet Peirson , Jane Skinner , Kalidass Subash Nethaji, Isla Kuhn, Effectiveness of virtual reality in the treatment of hand function in children with cerebral palsy: A systematic review. Journal of Hand Therapy (2019), 32; 426-434. DOI: 10.1016/j.jht.2018.01.006
Charles J. Upper extremity muscle activation in children with unilateral cerebral palsy during an auditory cued repetitive task: Effects on bimanual coordination. Journal of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach (2017) 10; 19–26. DOI: 10.3233/PRM-170407
Basu A. P., Janice Pearse, Susan Kelly, Vicki Wisher and Jill Kisler. Early intervention to improve hand function in hemiplegic cerebral palsy. Frontiers in Neurology, Neuro-pediatrics January 2015, Volume5, Article 281. DOI: 10.3389/fneur.2014.00281
Kim D.A., Jung-Ah Lee , Pil-Woo Hwang , Min-Jin Lee , Hyun-Kyung Kim, Jeong-Joon Park , Joshua H. You, Dong-Ryul Lee, Nam-Gi Lee. The Effect of Comprehensive Hand Repetitive Intensive Strength Training (CHRIST) Using Motion Analysis in Children with Cerebral Palsy. Ann Rehabil Med (2012); 36: 39-46. doi: 10.5535/arm.2012.36.1.39
Rameckers E.A.A., Y.J.M.Janssen-Potten, I.M.M.Essers, R.J.E.M. Smeets. Efficacy of upper limb strengthening in children with Cerebral Palsy: Acritical review. Research in Developmental Disabilities 36 (2015) 87–101. https://doi.org/10.1016/j.ridd.2014.09.024
Das S. P., G Shankar Ganesh. Evidence-based Approach to Physical Therapy in Cerebral Palsy. Indian Journal of Orthopaedics | Volume 53 | Issue 1 | January-February 2019. doi: 10.4103/ortho.IJOrtho_241_17
Friel K., Samit Chakrabarty, Hsing-Ching Kuo and John Martin. Using Motor Behaviour during an Early Critical Period to Restore Skilled Limb Movement after Damage to the Corticospinal System during Development. Journal of Neuroscience 4 July 2012, 32 (27) 9265-9276. doi: 10.1523/JNEUROSCI.1198-12.2012
Basu A, Eyre J. A plea for consideration of the less affected hand in therapeutic approaches to hemiplegia. Developmental Medicine Child Neurology (2012) 54:380. DOI:10.1111/j.1469-8749.2012.04242.x
Skold A, Josephsson S, Eliasson AC. Performing bimanual activities: the experiences of young persons with hemiplegic cerebral palsy. American Journal of Occupational Therapy (2004) 58:416–25. DOI: 10.5014/ajot.58.4.416
Lin J, Lumsden DE, Gimeno H, et al. The impact and prognosis for dystonia in childhood including dystonic cerebral palsy: a clinical and demographic tertiary cohort study. Journal of Neurology, Neurosurgery & Psychiatry 2014; 85:1239-1244. DOI: 10.1136/jnnp-2013-307041
Sakzewski L., Jenny Ziviani, Roslyn N. Boyd. Best Responders after Intensive Upper-Limb Training for Children with Unilateral Cerebral Palsy. Archives of Physical Medicine and Rehabilitation (2011). Vol 92. DOI: 10.1016/j.apmr.2010.12.003
Hung Y.C., Fawzia Shirzada, Maria Saleema, Andrew M. Gordonb. Intensive upper extremity training improved whole body movement control for children with unilateral spastic cerebral palsy. Gait & Posture (2020) 81, 67–72. DOI: 10.1016/j.gaitpost.2020.07.009
Ouyang R., Chieh-Ning Yang, Ya-Lan Qu, Manohar Prasad Koduri, Chi-Wen Chien. Effectiveness of hand-arm bimanual intensive training on upper extremity function in children with cerebral palsy: A systematic review. European Journal of Paediatric Neurology (2020) 25; 17-28. DOI: 10.1016/j.ejpn.2019.12.017
Alahmari K., Jaya Shanker Tedla, Devika Rani Sangadala, Debjani Mukherjee, Ravi Shankar Reddy, Kalyana Chakravarthy Bairapareddy, Praveen Kumar Kandakurti. Effectiveness of Hand-Arm Bimanual Intensive Therapy on Hand Function among Children with Unilateral Spastic Cerebral Palsy: A Meta-Analysis. European Neurology (2020), 7 DOI: 10.1159/000507325
Moreau N. G., Mary E. Gannotti. Addressing muscle performance impairments in cerebral palsy: Implications for upper extremity resistance training. Journal of Hand Therapy (2015) 28, 91-100. DOI: 10.1016/j.jht.2014.08.003
Rameckers E.A.A., Y.J.M.Janssen-Potten , I.M.M.Essers, R.J.E.M. Smeets. Efficacy of upper limb strengthening in children with Cerebral Palsy: Acritical review. Research in Developmental Disabilities 36 (2015) 87–101. http://dx.doi.org/10.1016/j.ridd.2014.09.024
Vaz D.V., Marisa Cotta Mancini, S´ergio Teixeira da Fonseca, Nayara Flamini Arantes, Tatiana Pessoa da Silva Pinto, Priscila Albuquerque de Ara´ujo. Effects of Strength Training Aided by Electrical Stimulation on Wrist Muscle Characteristics and Hand Function of Children with Hemiplegic Cerebral Palsy. Physical & Occupational Therapy in Pediatrics (2008) Vol. 28(4). DOI: 10.1080/01942630802307069
Barroso P.N., S.D. Vecchio, Y.R. Xavier, M. Sesselmann, P.A. Araújo, M. Pinotti. Improvement of hand function in children with cerebral palsy via an orthosis that provides wrist extension and thumb abduction. Clinical Biomechanics 26 (2011) 937–943. https://doi.org/10.1016/j.clinbiomech.2011.05.006
Diniari, N. K. S., & Aryani, L. N. A. (2022). Characteristics and pharmacological treatment options of delirium patients treated at Sanglah Central General Hospital . International Journal of Health & Medical Sciences, 5(1), 37-43. https://doi.org/10.21744/ijhms.v5n1.1835
Burtner P.A., Janet L. Poole, Theresa Torres, Amanda Manhke Medora, Rose Abeyta, Joanne Keene, Clifford Qualls. Effect of Wrist Hand Splints on Grip, Pinch, Manual Dexterity, and Muscle Activation in Children with Spastic Hemiplegia: A Preliminary Study. JOURNAL OF HAND THERAPY (2008), 36-43. DOI: 10.1197/j.jht.2007.08.018
Yıldızgören M.T., Güldal Funda Nakipglu Yüzer, Timur Ekiz, Özgirgin N. Effects of Neuromuscular Electrical Stimulation on the Wrist and Finger Flexor Spasticity and Hand Functions in Cerebral Palsy. Pediatric Neurology 51 (2014) 360-364. DOI: 10.1016/j.pediatrneurol.2014.05.009
Alhusaini A., Saber Fallatah, Ganeswara Rao Melam & Syamala Buragadda. Efficacy of transcutaneous electrical nerve stimulation combined with therapeutic exercise on hand function in children with hemiplegic cerebral palsy. Somatosensory & Motor Research (2019), DOI: 10.1080/08990220.2019.1584555.
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2022). Post-pandemic health and its sustainability: Educational situation. International Journal of Health Sciences, 6(1), i-v. https://doi.org/10.53730/ijhs.v6n1.5949
Jackman M., Natasha Lannin, Claire Galea, Leanne Sakzewski, Laura Miller, Iona Novak. What is the threshold dose of upper limb training for children with cerebral palsy to improve function? A systematic review. Australian Occupational Therapy Journal (2020) ;00:1. DOI: 10.1111/1440-1630.12666
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.