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 (<i>ICF CP Core Set</i>) 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 <i>ICF CP Core Set</i> 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 <i>ICF CP Core Set</i> 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 <i>ICF CP Core Set</i> environmental supports: Health services, systems, and policies [<i>p</i> = 0.03]; Education and training services, systems, and policies [<i>p</i> = 0.01]; and the Environmental sum score [<i>p</i> ≤ 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.