Modified Constraint Induced Movement Therapy Versus Virtual Reality Training in Children With Cerebral Palsy

Effects of Modified Constraint Induced Movement Therapy Versus Virtual Reality Training in Children With Hemiplegic Cerebral Palsy

Children with hemiplegic cerebral palsy (CP) are characterized by motor impairments mainly lateralized to one side of the body, with greater upper limb than lower limb involvement; these impairments may further limit the daily activities and school participation of children with hemiplegic CP. For the improvement of activity limitations in hemipelagic cerebral palsy children will take 20 hemiplegic cerebral palsy children with the age of 5-16 year all participants will be randomly assign and use modified Constraint induced movement therapy and virtual reality techniques.

mCIMT and Hot pack will be given to group I and unaffected hand will immobilized by a volar resting splint extending from finger tips to the proximal forearm. Use splint every day for at least 5 waking hours individualized, 18-hour program of mCIMT every other day, 3 times per week during a 4-week period. Each modified CIMT session continued for 1.5 hours will give to group I on the other hand VR and Hot pack will give to group II and 18-hour VR program, every other day, 3 times per week for 4 weeks will give Each VR session continued for 1.5 hours. Then evaluate both groups on follow up.

All the data will be collected from Rising Sun Institute by using ABILHAND-KIDS questionnaire and Children's hand-use experience questionnaire. The reliability and validity of tools and mentioned.

The duration of study will be 6-months. Data will be analyzed with the help of SPSS 27

Inclusion Criteria:

• Age range between 5 to 16 years of age.
• Medical diagnosis of spastic hemiparetic CP.
• At least 20◦wrist and 10◦ active finger extension from full flexion.
• More movement deficits in 1 upper extremity (less than 2.5 on the Amount of Use scale (AOU) on the Pediatric Motor Activity Log (PMAL)).
• Muscle tone less than 3 on the Modified Ashworth Scale.
• Normal or corrected-to-normal vision and hearing.
• Classified level I, II, or III of the Manual Ability Classification System ( MACS) for Children with CP

Exclusion Criteria:

• Health problems not associated with CP.
• Seizure hemispatial neglect.
• Orthopaedic surgery on the involved upper extremity.
• Botulinum toxin therapy for the affected upper extremity within the past 6 months or within the study period.
• Balance problems