Does Context Matter? Mastery Motivation and Therapy Engagement of Children with Cerebral Palsy
Laura Miller1,2, Jenny Ziviani3, Robert S Ware4
1a School of Allied Health , Australian Catholic University , Brisbane , Australia.
Insights
Children with unilateral cerebral palsy (UCP) receiving intensive hybrid constraint-induced movement therapy (hCIMT) showed greater engagement despite lower initial persistence. Mastery motivation predicted engagement in upper limb interventions for UCP.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Motor Control
Background:
- Children with unilateral cerebral palsy (UCP) often face challenges in upper limb (UL) function.
- Goal-directed interventions are crucial for improving motor skills in UCP.
- Understanding the role of mastery motivation in intervention engagement is vital.
Purpose of the Study:
- To investigate if baseline mastery motivation predicts engagement in UL interventions for children with UCP.
- To compare engagement levels between two distinct UL intervention approaches.
Main Methods:
- 44 children with UCP (mean age 7y 10m, MACS I-II) participated.
- Interventions included intensive Hybrid Constraint Induced Movement Therapy (hCIMT) or distributed occupational therapy (OT).
- Mastery motivation (DMQ) and engagement (PVQ) were assessed at baseline and during interventions.
Main Results:
- Children in hCIMT showed lower baseline persistence but higher volitional and exploration scores.
- Greater object-oriented persistence in hCIMT correlated with task-directedness, challenge-seeking, exploration, and volitional engagement.
- hCIMT group demonstrated superior engagement compared to individual OT.
Conclusions:
- Despite lower initial persistence, children in hCIMT exhibited enhanced engagement in goal-directed UL tasks.
- Mastery motivation, particularly persistence, influences exploration and engagement within hCIMT for UCP.
- hCIMT may foster greater engagement in children with UCP compared to traditional OT.
Aims:
To determine if mastery motivation at baseline predicts engagement in two goal-directed upper limb (UL) interventions for children with unilateral cerebral palsy (UCP).
Methods:
Participants were 44 children with UCP, mean age 7 years 10 months, Manual Ability Classification System level I (N = 23) or II (N = 21). Twenty-six children received intensive novel group-based intervention (Hybrid Constraint Induced Movement Therapy, hCIMT) and 18 received distributed individual occupational therapy (OT). Caregivers completed the Dimensions of Mastery Questionnaire (DMQ) parent-proxy report at baseline. Children's engagement was independently rated using the Pediatric Volitional Questionnaire (PVQ). Associations between children's mastery motivation and engagement were examined using linear regression.
Results:
Children who received hCIMT had lower DMQ persistence at baseline (p = .05) yet higher PVQ volitional (p = .04) and exploration (p = .001) scores. Among children who received hCIMT, greater object-oriented persistence was associated with task-directedness (β 0.25, p = .05), seeking challenges (β = 0.51, p = .02), exploration (β = 0.10, p = .03), and volitional scores (β = 0.23, p = .01).
Conclusion:
Despite having lower levels of persistence prior to engaging in UL interventions, children who received hCIMT demonstrated greater engagement in goal-directed tasks than children who received individual OT. Within hCIMT, children's motivational predisposition to persist with tasks manifested in their exploration and engagement in therapy.
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