Hand Function in Young Children with Cerebral Palsy: Current Practice and Parent-Reported Benefits

ABSTRACT

Aims: To (1) describe characteristics of current interventions to improve hand function in young children with Cerebral Palsy (CP), and explore factors associated with (2) increased likelihood of hand and ADL training and (3) child benefits of training. Methods: A cross-sectional design was used with parent-reported data and data from the Norwegian CP Follow-up Program (CPOP). A total of 102 children (53% of the cohort of newly recruited children in the CPOP, mean age: 30.3 months, SD: 12.1) were included. Hand function was classified according to the Mini-Manual Ability Classification System (Mini-MACS). Data were analyzed with descriptive statistics, cross-tables and direct multiple logistic regressions. Results: The majority of the children performed training of hand skills and ADL. Parents reported high amounts of training, and training was commonly integrated in everyday activities. Both parents (OR = 5.6, p < .011) and OTs (OR = 6.2, p < .002) reported more hand training for children at Mini-MACS levels II-III compared to level I. Parents reported larger child benefits when training was organized as a combination of training sessions and practice within everyday activities (OR = 7.090, p = .011). Conclusions: Parents reported that the children's everyday activities were utilized as opportunities for training, hence describing the intensity of therapy merely by counting minutes or number of sessions seems insufficient.

KEYWORDS.:

• Cerebral palsy
• children
• hand function
• current practice
• occupational therapy
• physical therapy

ABOUT THE AUTHORS

Gunvor Lilleholt Klevberg, OT, is a PhD student at the Research Centre for Habilitation and Rehabilitation Models and Services (CHARM) at the Faculty of Medicine, University of Oslo, Norway. Sigrid Østensjø, PT, is Associate Professor at the Masterprogram in Rehabilitation and Habilitation at the Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Norway. Sonja Elkjær, OT, is coordinator in the Cerebral Palsy follow-up Program in the Department of Neurosciences for Children at Oslo University Hospital, Norway. Ingvild Kjeken, OT, is Professor at the Program of Occupational Therapy, Prosthetics and Orthotics at the Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, and in the National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Norway. Reidun Birgitta Jahnsen, PT, is leader of the Cerebral Palsy Follow-up Program in the Department of Neurosciences for Children at Oslo University Hospital, a senior researcher and Associate Professor at the Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, and at Sunnaas Rehabilitation Hospital, Nesodden, Norway.