There was insufficient evidence to determine whether occupational therapy interventions to improve the use of the upper limb also enhanced social participation in children with cerebral palsy

Prepared by:

Claire Hyland, Jessica Campbell, & Mary-Lou Taft
(4th Year Occupational therapy students)
and Christine Imms (Lecturer)
La Trobe University.
Email:  c.imms@latrobe.edu.au

Date:

December 2005

Review Date:

December  2007

Clinical Question:

 Do occupational therapy interventions that improve upper limb use also enhance social participation in children with cerebral palsy?

Clinical Scenario:

Cerebral palsy is a common childhood disorder arising early in life from a non-progressive congenital or acquired abnormality of the brain. Children with cerebral palsy often have difficulties that affect the use of their hands and therefore have limited opportunities to participate and experience the things that occur in everyday life. For example, a child with upper limb spasticity may have difficulties holding a pencil, manipulating cutlery, or putting on a jumper.
The focus of occupational therapy has traditionally been on reducing the child’s impairment to improve motor and functional abilities and research to-date has primarily explored these issues. Occupational therapists are also interested in the promotion of participation, well-being and quality of life. The physical disability and paucity of movement experienced by children with cerebral palsy is assumed to impact their social participation. For example, a child with upper limb spasticity may have difficulty keeping up with peers on play equipment in the school yard and consequently be excluded from play activities and games with friends. It is important for social participation to be sufficiently understood and measured as an outcome.
The purpose of this CAT is to review current research evidence to investigate the assumption that occupational therapy interventions that improve upper limb use also enhance social participation in children with cerebral palsy.

Clinical Bottom Line:

There was insufficient evidence to answer the clinical question. Further research is required to determine whether occupational therapy interventions that improve upper limb use, also enhance social participation for children with cerebral palsy.

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