Upper Limb Treatment Principles in Intensive Functional Therapy in School-Aged Children and Adolescents with Cerebral Palsy ‘Guidance for therapists: Guidance for therapists

2019 
Aims: To develop a consensus on which upper limb treatment approach is appropriate for children with unilateral USCP and to formulate a practical guideline for clinical reasoning based on the criteria of functional therapy. Method: The FuncRehab-Cycle, coreset of tests, specific therapy components and ICF is used as a framework for clinical reasoning to enable choices for specific functional therapy approaches in upper limb treatment. Results: Practical guideline for clinical reasoning based on criteria of functional therapy was developed to make choices between Modified CIMT, Hybrid-CIMT, BIMT or BoNT-A and BIMT or functional bimanual strength training. Conclusions: Consensus was reached to realize a framework for clinical reasoning as a guidance for BIMT and H-CIMT, but not for M-CIMT and treatment options prior to BIMT or H-CIMT Aims: To develop a consensus on which upper limb treatment approach is appropriate for children with unilateral USCP and to formulate a practical guideline for clinical reasoning based on the criteria of functional therapy. Method: The FuncRehab-Cycle, coreset of tests, specific therapy components and ICF is used as a framework for clinical reasoning to enable choices for specific functional therapy approaches in upper limb treatment. Results: Practical guideline for clinical reasoning based on criteria of functional therapy was developed to make choices between Modified CIMT, Hybrid-CIMT, BIMT or BoNT-A and BIMT or functional bimanual strength training. Conclusions: Consensus was reached to realize a framework for clinical reasoning as a guidance for BIMT and H-CIMT, but not for M-CIMT and treatment options prior to BIMT or H-CIMT as a very helpful decision tool in rehabilitation.
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