Home-Based Telerehabilitation to Prevent Post-Modified Constraint-Induced Movement Therapy Regression in Unilateral Cerebral Palsy: A Randomized Controlled Trial.

Abstract

Aims: To determine the potential of low-end high-intensity home-based hand-arm bimanual intensive therapy (H-HABIT) in mitigating post-modified constraint-induced movement therapy (mCIMT) regression in children with unilateral cerebral palsy (UCP).

Methods: Twenty-two children (aged 4-12 years) with UCP were assigned to either the experimental (n = 12) or control group (n = 10). Both groups completed 30 h of mCIMT for three weeks, followed by 30 h of H-HABIT for five weeks in the experimental group and none in the control group. Assessments, including the assisting hand assessment (AHA) and other standardized measures, were performed at baseline, post-mCIMT, and post-H-HABIT. Triaxial accelerometers were worn on both wrists during each phase to monitor the activity.

Results: The experimental group showed AHA scores from baseline to post-H-HABIT, with a significant time × group interaction (p = 0.001, ƞ² = 0.29) indicating distinct trajectories from the control. In contrast, actigraphy-based measures of the upper limb remained stable over time. Caregiver feedback for H-HABIT showed that 83.33% found the guidelines easy to follow, and 91.67% rated therapist interactions as helpful.

Conclusions: H-HABIT may help prevent post-mCIMT regression. Further research should refine task selection and explore advanced assessment methods to better capture real-world function.