The effect of the modified constraint-induced movement therapy administered on consecutive or intermittent days on upper extremity function in individuals with hemiparetic cerebral palsy

The aim of the study is investigate effect of modified constraint-induced movement therapy (mCIMT) administered on consecutive or intermittent days on upper extremity function in individuals with hemiparetic Cerebral Palsy (CP). Thirty-three individuals with hemiparetic CP were included in the study. The individuals were separated into three groups: consecutive mCIMT (n =11), intermittent mCIMT (n=11), and control group (n=11). The mCIMT program was implemented in the consecutive mCIMT group as 6 hours a day for consecutive 10 days, and in the intermittent mCIMT group as 6 hours a day for intermittent 10 days (5 weeks, twice a week). An intensive motor exercise program was applied in company with a physiotherapist in 1 hour of the 6-hour period. The arm sling continued to be used for the remaining 5 hours. The control group continued the classical physiotherapy programs for 45 minutes a day, 2 days a week. The evaluations were made before the treatment and 10 days and 5 weeks after the treatment. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Jebsen-Taylor Hand Function Test (JTHFT), Children's Hand Use Experience Questionnaire (CHEQ), Abilhand Kids Questionnaire, Pediatric Evaluation of Disability Inventory (PEDI), and surface EMG (sEMG) were used to evaluate the individuals. As a result of the study, improvements were achieved in all groups, and the use of upper extremities in daily life activities (p<0.01), speed of performing the activities (p<0.001), grasping efficiency (p<0.001), the amount of a decrease in the individual's sense of discomfort while performing activities (p<0.001), and the level of independence in daily self-care activities (p<0.05) on the affected side in both the consecutive and intermittent mCIMT groups were better than the control group. Since the gain levels in mKZHT groups are similar (p> 0.05), it was concluded that administration of mCIMT on intermittent days facilitated the adaptation of a child by reducing the stress on the child, it was concluded to be a more tolerable method and could be more effective. Keywords: Modified Constraint-İnduced Movement Therapy, Hemiparetic Cerebral Palsy, Surface Electromiyography