Children with cerebral palsy hemiplegia present a restriction in the daily activities due to
the limitation in the active movement of the affected upper extremity.
The mirror therapy (MT) in children with hemiparesis produces an improvement in the quality
of movement and in the perception of the affected upper extremity. The action-observation
therapy (AOT) favors the motor behaviour of the affected upper extremity through the
observation of sequences of systematic activities and their posterior execution. It also
produces an increase in the excitability of the corticospinal tract, originating muscular
pattern contraction similar to the observed ones and favoring the motor activity.
The combination of both therapies might improve the quality of movement of the upper
extremity and provide a major cortical activation and increase the spontaneous use on having
created the only protocol of intervention which includes the benefits of both interventions.
The principal aim of this study is to analyze the influence of the quality of movement in the
spontaneous use of the upper extremity affected in children with hemiparesis as well as the
improvement of both variables across MTAO. Another specific aim will be to determine if "the
non-use" is determined by the quality of the movement of the segment, if the MTAO reduces
"the non-use" of this extremity as well as to obtain a protocol of intervention that
increases the quality of movement and the spontaneous long-term use.
A randomized controlled trial will be carry out in children with hemiparesia between 6 and 12
years, with a spontaneous use of the hand according to the scale HOUSE, a level Manual
Ability Classification System (MASC) I-III and a good cooperation and cognition. Those with a
severe spasticity, previous surgery of the upper extremity and the use of botox will be
excluded. The children will be divided in two groups. The experimental group will receive for
20 days a daily therapy of 15 minutes at home of MT and 45 of AOT, whereas the control group
will receive 60 minutes of AOT.
Four measurements will be obtained: basal situation, at the end of the treatment and measures
of follow-up to 3 and 6 months after the end of the treatment. Despite the sociodemographic
variables, measures of the quality of the movement, the spontaneous use of the upper
extremity, the questionnaire CHEQ and the AHA scale.