{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:06:14Z","timestamp":1787785574151,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"s4","license":[{"start":{"date-parts":[[2011,9,21]],"date-time":"2011-09-21T00:00:00Z","timestamp":1316563200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:p>Impaired hand function is among the most functionally disabling symptoms of unilateral cerebral palsy. Evidence\u2010based treatment approaches are generally lacking. However, recent approaches providing intensive upper extremity training appear promising. In this review, we first describe two such approaches, constraint\u2010induced movement therapy (CIMT) and bimanual training (hand\u2013arm bimanual intensive therapy). We then summarize findings across more than 100 participants in our CIMT\/bimanual training studies since 1997. We show that (1) at high intensities, CIMT and bimanual training improve dexterity and bimanual upper extremity use; (2) bimanual training may allow direct practice of functionally meaningful goals, and such practice may transfer to unpracticed goals and improve bimanual coordination; (3) 90\u2003hours of CIMT and bimanual training leads to greater improvements than 60\u2003hours of the same treatments; (4) higher doses may be required for bimanual training; (5) increased dosing frequency and shaping may be needed for older children; and (6) combined CIMT\/bimanual approaches may be useful, but require sufficient intensity. Together these findings suggest that dosage (treatment amount and frequency), more so than ingredients, may well be the key to successful training protocols, especially for older children. Such rehabilitation efforts should be \u2018child\u2010friendly\u2019, and as least invasive as possible, especially because these approaches may be provided throughout development.<\/jats:p>","DOI":"10.1111\/j.1469-8749.2011.04066.x","type":"journal-article","created":{"date-parts":[[2011,9,25]],"date-time":"2011-09-25T16:20:28Z","timestamp":1316967628000},"page":"56-61","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":111,"title":["To constrain or not to constrain, and other stories of intensive upper extremity training for children with unilateral cerebral palsy"],"prefix":"10.1111","volume":"53","author":[{"given":"ANDREW M","family":"GORDON","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,9,21]]},"reference":[{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-3335"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-8-14"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2009.03364.x"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2003.tb00884.x"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/63.1.36"},{"key":"e_1_2_13_7_2","first-page":"371","volume-title":"Behavioral Psychology in Rehabilitation Medicine: Clinical Applications","author":"Taub E","year":"1980"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-4886(89)80005-6"},{"key":"e_1_2_13_9_2","first-page":"347","article-title":"Technique to improve chronic motor deficit after stroke","volume":"74","author":"Taub E","year":"1993","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.17.2095"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001577-200107000-00003"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2006.tb01332.x"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1009"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/08830738060210110401"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2005.tb01132.x"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03119.x"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309359767"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269215507080783"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.00770.x"},{"key":"e_1_2_13_20_2","first-page":"151","volume-title":"Physical Therapy for Children","author":"Gordon AM","year":"2011"},{"key":"e_1_2_13_21_2","first-page":"202","volume-title":"Encyclopedia of Neuroscience","author":"Martin JH","year":"2009"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2011.04055.x"},{"key":"e_1_2_13_23_2","first-page":"160","volume-title":"Improving Hand Function in Children with Cerebral Palsy: Theory, Evidence and Intervention","author":"Gordon AM","year":"2008"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280600947591"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2006.02039a.x"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.00830.x"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03166.x"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968311402508"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2010.04.007"},{"key":"e_1_2_13_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2011.05.038"},{"key":"e_1_2_13_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-009-2049-1"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20297"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21108"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026025408742"},{"key":"e_1_2_13_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03220.x"},{"key":"e_1_2_13_36_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162205000708"}],"container-title":["Developmental Medicine &amp; 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