Upper Extremity Training Improved Whole Body Movements for Children with Cerebral Palsy

Do you work with children who have a diagnosis of hemiplegia? Many of you are probably familiar with the benefits of Constraint Induced Movement Therapy (CIMT) and Hand Arm Bimanual Intensive Therapy (HABIT) for children with unilateral spastic cerebral palsy. Did you know that recent research also indicates that this type of upper extremity training improves whole body movements too?

Methodology of the Study

The researchers wanted to evaluate the effects of Constraint Induced Movement Therapy (CIMT) and Hand Arm Bimanual Intensive Therapy (HABIT) on bimanual coordination and gait control during a complex whole body task. The participants includes 16 children with congenital hemiplegia (ages 6-12 years old who were randomly assigned to a CIMT or HABIT intervention group for 6 hours per day of training for 15 days. Using 3-D kinematic analysis, the children were evaluated before and after training while performing two whole body tasks (walking with and without carrying a tray).

Results of the Study on Upper Extremity Training in Children with Cerebral Palsy

Following data analysis the researchers determined the following:

• following the HABIT training, the children in that group increased the symmetry in height of their hands during tray carrying (more leveled tray).
• the children in the CIMT and the HABIT groups decreased the lateral motion of the tray.
• increased speed and stride length was recorded in the CIMT groups for both the walking and tray carrying tasks.
• both groups increased their minimum toe clearance.

Conclusion

The researchers concluded that the two types of intensive upper extremity training provided significant improvements to whole body movement control for children with spastic hemiplegia cerebral palsy. It was recommended that future studies should focus on the effects of such combined training because there are extensive interactions between the upper and lower extremities in real-world activities.

Reference: Hung, Y. C., Shirzad, F., Saleem, M., & Gordon, A. M. (2020). Intensive upper extremity training improved whole body movement control for children with unilateral spastic cerebral palsy. Gait & Posture, 81, 67-72.

Resources to Help Children with Upper Extremity Training

Therapeutic Play Activities for Children digital download includes 100 play activity pages and 12 tip sheets.  The play activities encourage the development of fine motor skills, bimanual skills, rolling, crawling, tall kneeling, standing balance and cruising with a strong focus on children with cerebral palsy.