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Pediatric Bimanual Therapy: A Scoping Review of Patients, Methods, and Outcomes
Bimanual therapy, also referred to as intensive bimanual training, engages patients in active play or practice to improve the use and coordination of both hands. Bimanual therapy is different from similar unimanual therapies, like constraint-induced movement therapy (CIMT), because it promotes simultaneous use of both hands.
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How Does Cerebral Palsy Affect The Body?
Cerebral Palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. Depending on the part of the brain that is injured depends on how someone’s muscle tone will be effected. For people with spastic CP they have increased muscle tone because of the part of the brain that's injured. If causes very tight muscles which in turn effects the movement of the joints and of the limbs. For others who have dyskinetic CP they lose the ability to have voluntary control over their muscles, and they can have jerky and uncontrolled movement patterns.
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What is Constraint Induced Movement Therapy?
Upper limb therapies and interventions have been well studied in cerebral palsy. Different interventions that have good evidence are Constraint Induced Movement Therapy (CIMT) and Bimanual Therapy. CIMT has been shown to be successful in children with hemiplegic cerebral palsy (CP). CIMT uses a splint to physically constrain the uninvolved arm and encourage them to use the more involved or affected arm.
Drawing of hand next to drawing of hand in sling for movement constraint therapy