Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Semin Pediatr Neurol. 2013 Jun;20(2):100-5. doi: 10.1016/j.spen.2013.06.001.
For children with hemiplegic cerebral palsy, bimanual abilities are central to independent function. Over the last decade, considerable attention has been given to 2 forms of extended practice therapy for the upper limb, constraint-induced movement therapy and intensive bimanual training. This article reviews the varying nature of these 2 approaches and the existing scientific rationale supporting them. Comparisons between these 2 intensive upper extremity training approaches indicate similar improvements in unimanual capacity and bimanual performance outcomes; however, when considering participant and caregiver goal achievement, evidence favors a bimanual approach. Careful selection of either therapy for this population requires consideration of individual and contextual factors in relation to treatment goals. The key ingredients and dose responses remain unknown. Treatment intensity, intrinsic motivation, and individualization of treatment are hypothesized as requisite in either approach.
对于偏瘫型脑瘫儿童来说，双手能力是独立功能的核心。在过去的十年中，人们对两种上肢的扩展练习疗法——强制性诱导运动疗法和强化双手训练——给予了相当多的关注。本文综述了这两种方法的不同性质和支持它们的现有科学依据。这两种强化上肢训练方法的比较表明，单手能力和双手表现结果都有类似的改善；然而，当考虑参与者和照顾者的目标实现时，有证据表明双手方法更有利。在考虑与治疗目标相关的个体和环境因素的情况下，需要仔细选择对这一人群的治疗方法。关键成分和剂量反应仍然未知。治疗强度、内在动机和治疗个体化被假设为这两种方法所必需的。
