Travail bimanuel versus travail unimanuel chez les enfants (0–18 ans) atteints de paralysie cérébrale spastique unilatérale

Objective

The objective of this work is to research, from the literature, whether there is an interest of bimanual training compared unimanual training in improving the upper limb function in children with unilateral spastic cerebral palsy.

Method

PubMed and Science Direct databases have been consulted to find articles since 2000 discussing the intensive bimanual therapy and the constraint induced movement therapy in these patients.

Results

Five articles were selected between 2011 and 2017, including two systematic reviews, a multisite clinical trial, a secondary analysis of a randomized controlled trial and a literature review.

Conclusion

The literature shows a strong but nonspecific recommendation for one or the other approach in improving the hemiparetic upper limb function. However, constraint induced movement therapy appears to be more effective in improving grip in the injured hand and there is a weak recommendation for intensive bimanual therapy in improving coordination between limbs and for bimanual activities. The conclusion would be to approach these two therapies by making them complementary and to link unimanual training and bimanual training in the rehabilitation of children with unilateral spastic cerebral palsy.