Summary of findings for the main comparison. Constraint induced movement therapy (CIMT) compared to low‐dose comparison for children with unilateral cerebral palsy.

Constraint induced movement therapy compared to low‐dose comparison for children with unilateral cerebral palsy
Patient or population: children with unilateral cerebral palsy Setting: mixed (home, clinic, laboratory, pre‐school) Intervention: constraint induced movement therapy Comparison: low‐dose comparison
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with low‐dose comparison	Risk with constraint induced movement therapy
Bimanual performance Assessed with: Kids‐Assisting Hand Assessment Scale from: 0 to 100 Follow‐up: immediately postintervention	The mean bimanual performance in the control groups ranged from 0.57 to 1.0 AHA units	The mean bimanual performance in the intervention groups was 5.44 AHA units higher (2.37 higher to 8.51 higher)	‐	39 (2 RCTs)c	⊕⊕⊝⊝ Lowa,b	Higher score indicates improved bimanual performance.
Unimanual capacity Assessed with: Melbourne Assessment Scale from: 0 to 100 Follow‐up: immediately postintervention	The mean unimanual capacity in the control group was−0.05 points	The mean unimanual capacity in the intervention group was 1.98 points higher (1.55 lower to 5.51 higher)	‐	23 (1 RCT)	⊕⊝⊝⊝ Very lowa,b,d	Higher score indicates improved unimanual capacity.
Unimanual capacity Assessed with: Quality of Upper Extremity Skills Test ‐ Grasps Scale from: 0 to 100 Follow‐up: immediately postintervention	The mean unimanual capacity in the control groups ranged from 0.9 to 2.5 points	The mean unimanual capacity in the intervention groups was 7.57 points higher (2.10 higher to 13.05 higher)	‐	103 (2 RCTs)	⊕⊝⊝⊝ Very lowa,b,c,e	Higher score indicates improved unimanual capacity.
Manual ability ‐ not measured	‐	‐	‐	‐	‐	No studies measured manual ability.
Self‐care ‐ not measured	See comment	See comment	‐	‐	See comment	No studies measured self‐care.
Individualised measures of performance ‐ not measured	See comment	See comment	‐	‐	See comment	No studies measured individualised performance.
Adverse events	The presence or absence of adverse events were not mentioned in 8/16 studies.		‐	454 (16 RCTs)	‐
	3 studies reported 4 children were unable to tolerate constraint induced movement therapy
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; MD: Mean difference; RCT: randomised controlled trial.
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

^aDowngraded one level due to risk of bias (all studies are at high risk of bias because it is not possible to blind personnel or participants to group allocation).
 ^bDowngraded one level due to small sample size (number of participants < 400).
 ^cDowngraded one level due to inconsistency (heterogeneity statistically significant: P < 0.10, I² > 40%).
 ^dDowngraded one level because results are from a single study.
 ^eTrial by Choudhary 2013 was registered in Clinical Trials Registry of India. Register stated one of the outcomes was: “To assess parent's perception of improvement in upper extremity function after four weeks of therapy and eight week follow‐up, using parent questionnaire.” No parent perception data were reported. We did not downgrade the body of evidence for unimanual capacity based on this finding.