Exploring Engagement as a Key Ingredient in the Efficacy of CIMT and HABIT Interventions for Children with Unilateral...

Person-level engagement, though well studied in counseling, mental health, and adult rehabilitation, is also critical in pediatric rehabilitation, yet it remains underexplored in motor learning interventions for children with unilateral spastic cerebral palsy (USCP). This study investigated how individual characteristics, including age and mastery motivation, influenced person-level engagement and examined how engagement affected motor outcomes.

A retrospective analysis was conducted involving 49 children with USCP aged 6-17 years who participated in either constraint-induced movement therapy (CIMT) or hand-arm bimanual intensive therapy (HABIT). Engagement was assessed through video coding and behavioral questionnaires, while hand function was evaluated using three standardized tests.

Findings indicated that age was significantly related to engagement. Engagement measures correlated with improvements in hand capacity as measured by the Jebsen-Taylor Hand Function Test, but not with performance on the Assisting Hand Assessment.

The results highlighted the relationship between age and engagement, emphasizing the importance of age-appropriate intervention strategies. Engagement played a role in improvements observed on capacity-based hand function tests, suggesting that engagement during therapeutic camps may be more critical for capacity-based than for performance-based motor activities. These insights support the design of targeted, age-appropriate interventions that optimize therapeutic outcomes for children with USCP.