Mirror therapy (MT) (affected limb is masked inside the mirror box) and modified constraint induced movement therapy (mCIMT) (unaffected limb is constrained during therapy hours) are well established and effective therapies in the upper extremity functioning of children with Cerebral Palsy (CP). But comparing the effectiveness of MT and mCIMT is an understudied area, especially in CP. The aim of this study was to compare the effectiveness MT with mCIMT in the rehabilitation of persons with hemiplegic CP post orthopaedic selective spasticity surgery (OSSCS).

A prospective clinical trial was conducted among 80 persons with CP, who were selected and randomly assigned into two groups. All the persons underwent OSSCS of forearm flexors and pronators of affected upper limb and were undergoing rehabilitation with a sequenced protocol based physical and occupational therapy. Group A (n=40) received MT (6 weeks-1hour/day), Group B (n=40) received mCIMT (6 weeks-1hour/day) and both the groups received regular intensive physical and occupational therapy apart from the above interventions. The primary outcome measures included were the Besta scale and Melbourne assessment of upper extremity function (MAUULF). Outcomes were measured at baseline, 6 weeks after the treatment and follow-ups at 1 month and 3 months later.

After six weeks of treatment, the mCIMT group showed significant improvements compared to the MT group in both Besta (P<0.01) and MAUULF (P<0.01) scores for hemiplegic upper extremity who underwent OSSCS. The obtained outcomes were maintained at 1 month and 3 months follow up also.

Modified CIMT showed greater improvement than MT in the upper extremity function of persons with hemiplegic CP. However, both the groups improved in their outcomes compared to baseline.