Functional Profiles and Baseline Correlates of Hand Function Change in Youth with Unilateral Cerebral Palsy Following Constraint-Induced Movement Therapy

Angela Shierk ^1,2, Ashlie Frederiksen ^1,3, Fabiola Reyes ^1,2

⁰Scottish Rite for Children, Frisco, TX, USA.

Occupational Therapy in Health Care +

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December 10, 2025

View abstract on PubMed

Summary

Constraint-induced movement therapy improved hand function in children with unilateral cerebral palsy. Environmental supports like health services and education positively correlated with functional gains, highlighting their importance for independence.

Area Of Science

Rehabilitation Medicine
Pediatric Neurology
Occupational Therapy

Background

Unilateral cerebral palsy (UCP) significantly impacts hand function in children.
Constraint-induced movement therapy (CIMT) is a common intervention for UCP.
Understanding factors influencing CIMT outcomes is crucial for optimizing therapy.

Purpose Of The Study

To describe functional profiles of children with UCP undergoing CIMT.
To correlate changes in hand function post-CIMT with International Classification of Functioning, Disability, and Health (ICF) factors.
To identify characteristics associated with better response to CIMT.

Main Methods

23 children with UCP (aged 5.0-13.5 years) participated in a 2-week CIMT program.
The ICF CP Core Set was administered at baseline.
Hand function changes were assessed using the Assisting Hand Assessment (AHA) pre- and post-intervention.

Main Results

Functional profiles were established across ICF domains for children with UCP in CIMT.
Positive correlates to improved hand function (AHA scores) included specific environmental supports.
Key environmental supports were Health services, systems, and policies (p=0.03) and Education and training services, systems, and policies (p=0.01).

Conclusions

Environmental factors, beyond motor deficits, significantly influence functional improvement in children with UCP post-CIMT.
Health services and educational support systems are important correlates of better hand function outcomes.
Optimizing environmental supports may enhance functional independence in children with UCP.

Keywords:

Cerebral palsy constraint-induced movement therapy disability and health (ICF) environment international classification of functioning virtual reality