Effectiveness of constraint-induced movement therapy compared with bimanual intensive training in children with spastic unilateral cerebral palsy - a systematic review

Abstract

The aim of this systematic literature review was to assess the effectiveness of Constraint-Induced Movement Therapy (CIMT) compared with Bimanual Intensive Training (BIT) across the domains of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) in children with spastic unilateral cerebral palsy (CP). The following databases were searched: CINAHL, Cochrane Library, EMBASE, MEDLINE, PEDro, PsycINFO, and Pubmed. The primary outcomes of interest were bimanual upper extremity (UE) function, unimanual UE function and participation. The secondary outcomes of interest were individualised goals and quality of life. Six RCTs met the inclusion criteria, one with high, three with moderate and two with low quality of conduct. The measurement instruments used assessed items across the ICF-CY domains making it not possible to comprehensively report the findings using the ICF-CY, or to conduct analyses of possible interlinkages between the domains. Based on the findings in the RCTs included in this systematic review, it is not possible to confidently say that CIMT or BIT is more effective than the other in improving manual ability, participation and individual goals in children with unilateral CP at group-level.