Effects of Constraint-Induced Therapy on Hand Function in Children with Hemiplegic Cerebral Palsy

PURPOSE: The effects of constraint-induced therapy on hand function of the involved upper extremity were examined in three children with hemiplegic cerebral palsy. METHODS: In these case reports, the noninvolved upper extremities of the children were constrained six hours daily for 14 consecutive days. Hand function, strength, sensation, and fingertip force coordination were examined pre- and postintervention. RESULTS: The results indicated that there was an improvement in hand function for two of the three children and an improvement in two-point discrimination threshold values for all children. While there was no consistent change in fingertip force coordination during precision grip across children, one child demonstrated a consistent decrease in duration of temporal phases of fingertip force coordination and two children demonstrated a reorganization of the grip-lift synergy of the involved hand. CONCLUSION AND CLINICAL IMPLICATIONS: Improvement in hand function is not captured by any one measure. The effectiveness of this intervention is promising but may be dependent on the severity of the impairment.