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

This study aimed to describe the functional profiles of children with unilateral cerebral palsy who participated in constraint-induced movement therapy and correlate change in hand function after the intervention with factors across the International Classification of Functioning, Disability, and Health (ICF). Twenty-three children aged 5.0 to 13.5 years (SD = 3.08) with unilateral cerebral palsy participated in a two-week (60-h) group-based constraint induced movement therapy program as part of a blinded randomized controlled trial comparing a constraint induced movement therapy camp to constraint induced movement therapy plus virtual reality. The International Classification of Functioning, Disability, and Health Brief Core Set for Cerebral Palsy (ICF CP Core Set) was administered at baseline. Changes in hand function were measured using the Assisting Hand Assessment at baseline and after intervention. Descriptive statistics were used to summarize the ICF CP Core Set results, providing functional profiles of children with unilateral cerebral palsy who participated in constraint induced movement therapy across ICF domains. Assisting Hand Assessment change scores were correlated with the ICF CP Core Set using Spearman's rank analysis to identify characteristics associated with favorable responses to intervention. Positive correlates to change in hand function only included the following ICF CP Core Set environmental supports: Health services, systems, and policies [p = 0.03]; Education and training services, systems, and policies [p = 0.01]; and the Environmental sum score [p ≤ 0.01]. While the clinical presentation of this population necessitates a heavy focus on motor deficits, these findings highlight that environmental factors also play an important role in functional improvement and, ultimately independence in this population.