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.
Drooling is an important problem for many individuals with CP and there are a number of interventions available to treat symptoms. If an individual with CP or their caregiver have concerns about drooling it is important to discuss with a health care provider. Care pathways such as the AACPDM pathway can be a starting point for shared decision making. In all cases, working together as a team is important in choosing the best alternative. Children and adults with CP may have trouble with drooling, or saliva management. In the medical world, drooling is referred to as sialorrhea. Saliva plays an important role in eating but also can interfere with airway clearance and breathing, as well as social participation. When drooling has this kind of impact it becomes important to consider intervention.
Many children with cerebral palsy (CP) have difficulty controlling saliva. Drooling varies in severity and can be distressing for the children, families and caregivers. Chronic drooling is referred to as Sialorrhea and occurs as a result of limitations in a person’s ability to control and swallow oral secretions.
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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.