Hand Functions Following Prone-weight Bearing on Upper Limb with Active Elbow Extension Versus Modified Constraint Induced Movement Therapy in Children with Unilateral Cerebral Palsy - A Randomised Clinical Trial.

Only 38 children, from a single hospital, chosen by convenience rather than drawn at random from a wider population. 50 were assessed for eligibility. The two groups did not start level. The weight-bearing group scored lower on both subtests before treatment, so it had more room to gain, and the paper does not describe any adjustment for that. Both groups received an active treatment for the same two weeks, so this compares two therapies rather than a therapy against nothing. No follow-up. Nobody was reassessed after the two weeks, so whether the gains lasted is unknown. The paper describes the between-group difference as highly significant (p = 0.000), but the numbers in the table are within-group tests and the text does not say which analysis compared the two groups. Treatment was short, two weeks. The protocol describes three sessions a day, six days a week for two weeks, while the discussion refers to 42 treatment sessions; the two do not match. Only children who barely use the affected hand (MACS level IV or V) were included, so the results may not apply to children with milder involvement. The therapists delivering the treatments were not blinded, though the assessor scoring the children was. The reported visual motor integration change for the CIMT group is 5.80 in the text and 5.89 in the table.

The text provided contains no funding statement and no declaration of competing interests, so who paid for the work and what the authors declared is not reported in the material supplied.

A hurried reader could take this as proof that prone weight-bearing beats modified CIMT and change practice accordingly. Both groups improved, the weight-bearing group began the study with lower scores on both subtests so had more room to gain, treatment lasted only two weeks, and nobody was reassessed afterwards.