Skilled Bimanual Training Drives Motor Cortex Plasticity in Children With Unilateral Cerebral Palsy.

Only a small number of children were studied, so the results may not generalise. The paper reports 18 randomized children but also describes two groups of 10, so the analysed sample is unclear. One six-month follow-up was missing and was replaced with the group average. The study measured only motor cortex maps, so changes in other brain or spinal regions were not assessed. The clinical tests did not measure movement quality, so differences in how children moved may have been missed. The study used a high therapy dose, and the authors suggest this may have reduced differences between groups. The structured group received task progression, isolated movement practice, and functional goals together, so the contribution of any single component cannot be separated.

Do not conclude that structured training gives better hand function. Both groups improved hand function similarly, and the structured group received task progression, isolated movement practice, and functional goals together, so their separate contributions cannot be separated.