Abstract
To assess the effectiveness of modified constraint-induced movement therapy (mCIMT)
in improving upper limb function and grip strength in children with hemiplegic cerebral
palsy (CP). A comprehensive search was conducted from inception to August 2024. Eligibility
criteria were studies evaluating the effectiveness of mCIMT on upper limb function
in children with hemiplegic CP aged over 2 years. The following data was extracted
from each study: participant characteristics, intervention, outcome measures, follow-up,
and key findings. The risk of bias and the quality of the evidence were evaluated
using the PEDro scale and the grading of recommendations assessment development and
evaluation (GRADE), respectively. A meta-analysis using a random-effect model was
performed, and standardized mean difference (SMD) with a 95% confidence interval (CI)
was estimated for upper limb function and grip strength. A total of 25 studies (1,115
children) were included. PEDro scale revealed 12 good-quality studies, 8 fair-quality
studies, and 5 poor-quality studies. The currently available evidence showed a significant
large effect of mCIMT in improving upper limb function (SMD: 1.14 [95% CI: 0.46–1.83];
p = 0.001; 12 studies; 454 children; very-low-quality evidence) and significant medium
effect in improving grip strength (SMD: 0.63 [95% CI: 0.12–1.14]; p = 0.02; 3 studies; 92 children; low-quality evidence). mCIMT could improve upper
limb function and grip strength in children with hemiplegic CP. However, due to the
low and very low quality of evidence, further high-quality trials are needed to confirm
these effects. PROSPERO registration number (CRD42023413525).
Keywords
modified constraint-induced movement therapy - mCIMT - upper limb - rehabilitation
- hemiplegic cerebral palsy
