Upper Limb Capacity, Performance, and Leisure Participation in Children with Unilateral Cerebral Palsy

Children with unilateral cerebral palsy (uCP) experience pronounced sensorimotor impairments on one side of the body, impacting upper limb (UL) use and leisure participation. This study compares UL performance in children with uCP and typically developing (TD) children and examines, within the uCP group, the association between UL capacity, UL performance, and leisure participation. Twenty-one children with uCP (age: 11.2 ± 1.8 years) and 30 TD children (age: 10.6 ± 2.1 years) were recruited. UL performance was measured using accelerometry and expressed in activity counts per minute, UL capacity with the Jebsen-Taylor Hand Function Test, and leisure participation with the Children's Assessment of Participation and Enjoyment questionnaire. The uCP group showed markedly lower performance in their non-dominant side compared to the TD group (p < 0.001, ηp² = 0.57), while dominant-side performance showed no significant difference between groups. UL capacity, UL performance, and leisure participation were not correlated (r range: -0.06-0.20). Children with uCP remained active despite UL asymmetry. The lack of significant association between UL capacity, performance, and participation may reflect contextual factors. These findings highlight the importance of complementing accelerometry with measures capturing other dimensions of motor function (e.g., fine motor skills) for a more comprehensive assessment of real-world UL performance.