Development of Hand Use with and Without Intensive Training Among Children with Unilateral Cerebral Palsy in Scandinavia

ABSTRACT

Aim

To describe hand use development in children with unilateral cerebral palsy who did/did not participate in constraint-induced movement therapy (CIMT) before 7 years of age.

Method

The study included 334 participants (18 months–12 years) who were assessed with 1,565 Assisting Hand Assessments (AHAs) and categorized into no intensive training (NIT), CIMT (18 months–7 years), and Baby-CIMT (<18 months) groups.

Results

AHA performance at 18 months (AHA-18) was positively associated with development regardless of training. The CIMT group had lower AHA-18 performance than the NIT group (p = .028), but higher stable limit (p = .076). The age when 90% of development was reached was highest in the CIMT group (p = .014). Although non-significant, the Baby-CIMT group had higher mean curve than NIT and CIMT combined (AHA-18 p = .459, limit p = .477).

Conclusion

The CIMT group improved more over time than the NIT group. Intensive training extended the window of development, and Baby-CIMT might promote early development.

KEYWORDS:

• cerebral palsy
• children
• constraint-induced movement therapy
• development
• hand function
• intensive training

Acknowledgments

We would like to thank all the children and their families who participated in this research. We are also truly grateful for the work and effort of all the collaborating therapists who have helped us in recruiting participants and collecting data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17518423.2023.2193256.

Additional information

Funding

This work was funded by the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Oslo University Hospital, the Swedish Research Council (grant nos. 521-2013-3096 and 2016-01009), and the NordForsk (grant no. 82866). Special supporting grants were received from the Stockholm City Council (grant nos. 1411-1372, 20150153), Stiftelsen Frimurare Barnhuset i Stockholm, Norrbacka-Eugeniastiftelsen, and Sällskapet Barnavård.