Interventions to Promote Bimanual Activities and Participation in Daily Life Activities in Children with Cerebral Palsy: A Scoping Review

Abstract

Aims: To identify rehabilitation interventions and outcome measures that target bimanual activities and autonomy in activities of daily living (ADLs) in children with cerebral palsy.

Methods: This scoping review followed the Arksey and O'Malley framework. The literature search was conducted in five medical databases. Inclusion criteria were studies of children with cerebral palsy that delivered rehabilitation interventions targeting upper limb function and used valid outcome measures assessing bimanual activities or ADLs. The exclusion criteria were pharmacological or surgical interventions, reviews, expert opinions, protocols and qualitative studies. Two independent researchers screened titles/abstracts and full texts. Data related to the study participants, interventions, outcome measures and results were extracted.

Results: Eighty-nine publications were included in this review. Out of the 17 interventions identified, the most frequent were constraint-induced movement therapy (n = 29), virtual reality (n = 22), hand-arm bimanual intensive training (n = 12), bimanual intensive training (n = 11) and action observation (n = 6). All five interventions showed significant improvements on bimanual function, whereas all but action observation showed improvements in autonomy in ADLs. We identified 15 outcome measures capturing bimanual activities and 6 capturing autonomy in ADLs.

Conclusion: This scoping review provides essential information for the improvement of rehabilitation interventions for children with cerebral palsy.

Keywords: Bimanual coordination; cerebral palsy; motor training; occupational therapy; rehabilitation; upper extremity.