Hand Function in Young Children with Cerebral Palsy: Current Practice and Parent-Reported Benefits
Gunvor Lilleholt Klevberg1, Sigrid Østensjø2, Sonja Elkjær3
1a Research Center for Habilitation and Rehabilitation Models and Services (CHARM) , Institute for Health and Society, Faculty of Medicine, University of Oslo , Oslo , Norway.
Insights
Parents reported that children with Cerebral Palsy (CP) benefited most from hand and activities of daily living (ADL) training integrated into everyday routines. This highlights the importance of functional, context-based interventions for improving hand function in young children with CP.
Area of Science:
- Pediatric Rehabilitation
- Occupational Therapy
- Child Neurology
Background:
- Cerebral Palsy (CP) significantly impacts hand function in young children.
- Effective interventions are crucial for improving daily living activities (ADL) and overall quality of life.
- Current training approaches and their effectiveness require detailed characterization.
Purpose of the Study:
- To describe current interventions aimed at enhancing hand function in children with CP.
- To identify factors influencing the likelihood of receiving hand and ADL training.
- To explore the relationship between training methods and child benefits.
Main Methods:
- Cross-sectional study design utilizing parent-reported data and the Norwegian CP Follow-up Program (CPOP).
- Included 102 children (mean age 30.3 months) with CP, classified by the Mini-Manual Ability Classification System (Mini-MACS).
- Statistical analysis involved descriptive statistics, cross-tables, and multiple logistic regressions.
Main Results:
- Most children received hand skills and ADL training, often integrated into daily activities.
- Children with higher Mini-MACS levels (II-III) received more hand training compared to Level I (ORs 5.6-6.2).
- Combined training (sessions + daily practice) yielded greater reported child benefits (OR = 7.090).
Conclusions:
- Parent-reported training intensity, integrated into everyday activities, suggests traditional metrics (minutes/sessions) may be insufficient.
- Functional, context-based training approaches appear more beneficial for children with CP.
- Further research should consider the impact of integrated therapy on functional outcomes.
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.
