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Efficacy of forced-use therapy in hemiplegic cerebral palsy
Sung IY, Ryu JS, Pyun SB, Yoo SD, Song WH, Park MJ
Archives of Physical Medicine and Rehabilitation 2005 Nov;86(11):2195-2198
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine the efficacy of forced-use therapy (FUT) on the improvement of upper-extremity function in children with hemiplegic cerebral palsy (CP). DESIGN: Prospective case series. SETTING: Outpatient ambulatory clinic in South Korea. PARTICIPANTS: Thirty-one patients with hemiplegic CP were assigned to the FUT group (n = 18) or to the control group (n = 13). The mean age of the patients in the FUT group was 33.2 months and in the control group it was 43.2 months. INTERVENTIONS: The FUT group wore a short-arm Scotchcast on the unaffected arm for 6 weeks and also participated in a conventional rehabilitation program that included stretching exercises and functional occupational therapy for the upper extremity. The control group underwent the conventional rehabilitation program only. MAIN OUTCOME MEASURE: Hand function tests, including the box and block test (BBT), Erhardt Developmental Prehension Assessment (EDPA), and WeeFIM instrument taken before and after 6 weeks of treatment. RESULTS: Before treatment, there was no significant difference between groups in the BBT, EDPA, and WeeFIM scores. After 6 weeks of treatment, however, the FUT group showed significant improvement in the affected arm in the BBT and EDPA scores, compared with the control group (p < 0.05). The self-care score on the WeeFIM was also significantly improved in the FUT group (p < 0.05). CONCLUSIONS: FUT combined with a conventional rehabilitation program appears to be more effective than a rehabilitation program alone in improving affected hand function in children with hemiplegic CP.

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