Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Growth and Development Disorders in Pediatrics

Background:Upper limb dysfunction is a common symptom in children with cerebral palsy (CP), especially those with unilateral spastic CP (USCP) which intern has the potential to limit participation in life and causing distress to both children and parents. Objective:The purpose of this study was to compare the therapeutic effect among hand-arm bimanual intensive therapy (HABIT), modified constrained induced movement therapy (mCIMT) and task oriented training (TOT) on upper extremity functions and hand grip strength in children with unilateral spastic CP. Methods: Sixty USCP children of both genders with age range from five to eight years were randomly divided into three groups of equal number. Group (A) received HABIT,group (B) received mCIMT and group (C) received TOT.Treatment was conducted for 60 minutes, three days/week for three successive months. Peabody Developmental Motor Scale (PDMS-2) and Quality of Upper Extremity Skills Test (QUEST) were used to assess the upper extremity functions for all groups. Baseline Pneumatic hand held dynamometer was used to measure hand grip strength. Assessment was performed before as well as after the period of intervention. Results: Significant improvement in the visual motor integration and grasping subsets of PDMS-2, dissociated movements and grasp subtests of QUEST as well as hand grip strength in the three groups after intervention with a higher significant effect for group (B). Conclusion: All of the three physical therapy interventions (HABIT, mCIMT and TOT)could improve upper extremity functions for children with USCP with a more significant effect for mCIMT

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