Upper-limb movement in infants at risk for unilateral spastic cerebral palsy: A scoping review.

AIM: To identify and map current knowledge regarding early upper-limb movement in infants from birth to 12 months, which are indicative for development of unilateral spastic cerebral palsy (USCP). METHOD: A scoping review was conducted involving a comprehensive and systematic literature search in PubMed/MEDLINE, Embase, and CINAHL. Articles were screened according to title and abstract and relevant data were extracted. Studies were eligible if they included infants aged 0 to 12 months at risk of developing USCP and reported early upper-limb movement characteristics indicative of USCP. RESULTS: Twelve of 5482 studies were included. Three categories of assessments were recognized: (1) spontaneous upper-limb movements; (2) pre-reaching; and (3) upper-limb skills. Across these categories, asymmetry was observed, namely in spontaneous wrist and digit movements, pre-reaching trajectories, and reduced use of the contralesional hand in infants who developed USCP. From 15 weeks of age onwards, asymmetry was more evident not only in upper-limb movement patterns but also in object-related upper-limb skills. INTERPRETATION: Clinical signs of USCP in upper-limb movements are noticeable from the age of 12 weeks. Preceding signs may be subtle. Three-dimensional motion analysis and wearable sensors may enhance early detection, enabling timely diagnosis and intervention.