Effects of hand-arm bimanual intensive training the children with cerebral palsy on upper limb function rehabilitation and activity of daily living

Abstract

Objective To explore the effect of hand-arm bimanual intensive training on upper limb function rehabilitation and daily living ability of children with cerebral palsy. Methods Eighty-four children with cerebral palsy who came to Xinjiang Uygur Autonomous Region People’s Hospital from May 2014 to January 2016 were selected, and they were divided into control group and observation group by the time they came, each group had 42 patients. The patients in control group were treated by comprehensive rehabilitation training, and the patients in observation group were treated by hand-arm bimanual intensive training. The upper limb function and daily living ability score of two groups before and after treatment were compared, and the rehabilitation effect of the two groups were compared. Results Before the training, the grading of the modified Ashworth scale (MAS) for the affected upper limb of children in the control group and observation group was (2.31±0.85/2.28±0.91); the wrist dorsiflexion angle was [(16.84±5.25)°/(17.02±5.32)°]; the Peabody developmental motor scale-fine motor (PDMS-FM) of prehension and visual motor integration was [(34.96±6.47)/(35.12±6.63), (76.93±21.05)/(77.36±20.78)]; the quality of upper extremity skills test (QUEST) was (78.25±13.25/78.69±12.88); the modified Barthel index (MBI) of daily living ability was (50.24±10.63/49.84±10.49); and there were no statistical differences between above (P>0.05). After training, MAS score of the observation group was (1.18±0.49), which was significantly lower than that of the control group (1.87±0.76) (P<0.05); the active wrist dorsiflexion angle was (32.56±7.95)°; the PDMS-FM score was [(43.16±6.58), (85.26±19.66)]; the QUEST score was (86.52±11.06); the MBI score was (76.25±11.63), which was significantly higher than that of the control group (24.73±6.82)°, [(38.22±7.64), (79.25±22.03)], (81.37±12.43), (63.02±12.18); and there were statistical differences (P<0.05). Conclusion Hand-arm bimanual intensive training can significantly improve the structure and function of hemiplegic arm children with cerebral palsy, also improve children’s upper limb function, contribute to its growth and development, improve the children’s daily living ability, and it has important clinical value, is worthy of promotion in clinical practice. Key words: Hand-arm bimanual intensive training; Children with cerebral palsy; Upper limb function; Daily living ability