Service Delivery

Intensive upper limb intervention with self-management training is feasible and promising for older children and adolescents with unilateral cerebral palsy.

Geerdink et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

One 36-hour week of CIMT-BiT plus self-management gives big, lasting arm-skill jumps for school-age kids with unilateral CP.

✓ Read this if BCBAs running summer camps or intensives for tweens and teens with hemiplegic CP.
✗ Skip if Clinicians who only see infants or adults with CP.

01Research in Context

01

What this study did

Yvonne and her team ran a one-week camp for 8- to young learners with unilateral cerebral palsy.

Each child got 36 hours of intensive CIMT-BiT training plus daily self-management lessons.

They measured arm skills before camp, right after, and again three months later.

02

What they found

Kids made big jumps in how well they could use their weaker arm.

The gains stayed strong three months later with no extra therapy.

Parents and teens both said the week felt doable and useful.

03

How this fits with other research

Ding et al. (2017) also tested a short tech-based plan for teens with developmental disabilities.

They used video-chat workouts instead of in-person arm training, yet both studies kept teens engaged and showed clear gains.

Jameson et al. (2008) and Matson et al. (2008) prove that adding self-management to any package—peer tutoring or social-skills groups—helps skills stick.

Shih et al. (2011) gave kids with ADHD a Wii Remote to self-monitor limb movement, echoing the self-direction piece Yvonne added to arm therapy.

04

Why it matters

You can pack a full dose of arm therapy into one intensive week instead of stretching it over months.

Add short self-management lessons and the improvements last.

Try offering a spring-break or summer "arm boot camp" and teach each learner to track their own practice at home.

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Schedule a five-day block of 7-hour CIMT-BiT sessions and add a 15-minute daily self-management lesson where kids graph their own reps.

02At a glance

Intervention
other
Design
pre post no control
Sample size
20
Population
other
Finding
positive
Magnitude
large

03Original abstract

This study explored the feasibility and preliminary effectiveness of a short (one week) intensive intervention combining Constraint Induced Movement Therapy (CIMT) and bimanual training (BiT) to improve upper limb capacity and bimanual performance guided by individual goal setting in children and adolescents with unilateral cerebral palsy aged 8-18 years. Self-management training was added to the intervention to maximize the effect of training and to empower the participants in self-monitoring the effective use of their affected hand. Functional goals (Canadian Occupational Performance Measure), unimanual capacity (Box and Block Test), bimanual performance (ABILHAND-Kids, Children's Hand-use Experience Questionnaire (CHEQ)) and amount of use (Video Observation Aarts and Aarts - determine developmental disregard (VOAA-DDD-R)) were measured at baseline, one week and four months post intervention. Twenty children (mean age 9.5 years) participated. Repeated measures ANOVA was used to measure effects over time. Compared to baseline, there were significant improvements on all outcome measures. The largest effect sizes were found for the COPM-performance and COPM-satisfaction (Cohen's d=2.09 and d=2.42, respectively). The effect size was large for the ABILHAND-Kids (d=0.86), moderate for the CHEQ (d=0.70) and Box and Block Test (d=0.56), and small for the VOAA-DDD-R (d=0.33). All effects were retained at the four months post intervention assessment. The results of this study indicate that one-week (36h) intensive CIMT-BiT combined with self-management training is a feasible and promising intervention for improving the capacity of the upper limb and its use in bimanual activities in older children and adolescents with unilateral CP.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.06.013