An investigation of bilateral isokinematic training and neurodevelopmental therapy in improving use of the affected hand in children with hemiplegia.

Motor impairment in children with hemiplegic cerebral palsy leads to a predominance of use of the unaffected hand. This impedes development of bimanual skills and deprives the affected side of the stimulus needed for normal growth. Occupational therapists aim to improve use of the affected hand, traditionally using Neurodevelopmental Therapy. Empirical evidence is needed to support this treatment choice. Studies examining interlimb coupling in children with hemiplegia and other studies in adult stroke support a bilateral treatment approach. These single-case time-series experiments examined the effects of Neurodevelopmental Therapy and Bilateral Isokinematic Training on hand use in three children with hemiplegic cerebral palsy. Two of the three subjects displayed positive changes in use and movement of the affected hand in some tasks with Bilateral Isokinematic Training. Bilateral Isokinematic Training might be a potentially useful means of increasing frequency of use of the affected hand in some children with hemiplegic cerebral palsy.