The efficacy of an integrated training approach on upper limb muscle strength and muscle fatigue in children with unilateral cerebral palsy

Abstract

This research has two major purposes: (1) to investigate if modified Constraint-Induced Movement Therapy (mCIMT) in combination with Action Observation Therapy (AOT) is more effective in comparison to mCIMT alone to improve upper limb muscle strength and muscle fatigue in children with unilateral CP; (2) to explore the influencing factors on changes in muscle strength and muscle fatigue, such as age and hand function at baseline. Children diagnosed with spastic unilateral CP, with an age between six and 12 years old were recruited. A two-week day camp model in which children received intensive therapy was performed. The children were randomized to the mCIMT+AOT or mCIMT group. Grip strength and muscle fatigue were analysed in both groups with the Jamar dynamometer (E-link, Biometrics Ltd, Newport, UK). Muscle strength was assessed with Manual Muscle Testing (MMT). It can be concluded that an integrated training approach combining mCIMT and AOT did not enhance the effects on muscle strength and muscle fatigue in comparison to mCIMT alone in children with unilateral CP. However, both groups showed comparable significant improvements over time in grip strength and muscle strength, but not in muscle fatigue. Further research with larger sample sizes and optimization of the measurement of muscle strength and muscle fatigue is needed to confirm these results.