How Many Hours Does It Take a Child with CP to Improve Function?

What would your guess be? How many hours do you think it takes for a child with cerebral palsy to improve their functional skills? Researchers recently took a closer look at the high intensity dosing needed for upper limb training.

How the Study Was Completed

In order to quantify which rehabilitation training approaches and doses results in the largest clinical gains, the researchers completed a systemic review of 74 randomized controlled trials. There were studies for motor function and studies for individual goal achievement. The participants were all children with cerebral palsy ages 0 to 18 years old who received active upper limb training. Data was extracted and analyzed.

Drum Roll Please… How Many Hours Are Needed to Improve Function?

The researchers determined that approximately 40 hours of practice is needed to improve upper limb motor ability in children with unilateral cerebral palsy.

For all types of cerebral palsy, individual goals were acheived at a lower dose of 14 to 25 hours of practice when goal-directed interventions were provided.

The researchers concluded that to improve individual goals, children need to practice goals for more than 14-25 hr, combining face-to-face therapy with home practice. Based on the evidence in the research on children with unilateral cerebral palsy, in order to improve general upper limb function children need to practice for more than 30-40 hr.

In summary, interventions that set functional goals and include actual practice of those goals lead to goal achievement at a lower dose than general upper limb motor training.

Questions to Ponder

How did you do with your guess? Were you close?

Does this research influence how much you would recommend occupational or physical therapy direct services?

Does this research influence how much you will provide at home activities for the children that you service?

Reference: Jackman, M., Lannin, N., Galea, C., Sakzewski, L., Miller, L., & Novak, I. (2020). What is the threshold dose of upper limb training for children with cerebral palsy to improve function? A systematic review. Australian Occupational Therapy Journal.

Resources to Help Children With Cerebral Palsy Improve Function

Therapeutic Play Activities for Children digital download includes 100 play activity pages and 12 tip sheets.  The play activities encourage the development of fine motor skills, bimanual skills, rolling, crawling, tall kneeling, standing balance and cruising with a strong focus on children with cerebral palsy.

Teaching Motor Skills to Children with Cerebral Palsy and Other Movement Disorders is a must have reference for all therapists who work with children with cerebral palsy.   Whether you are a beginner or experienced therapist you will find the information concise, informative and very helpful to carry out everyday functional tasks including stretching with children with cerebral palsy. The book provides activity suggestions throughout the developmental sequence such as head control, tummy time, sitting, transitions, walking and beyond. 

Read More Research on Children with Unilateral Cerebral Palsy

HAND MOTOR FUNCTION IN UNILATERAL CEREBRAL PALSY – BENEFITS OF PEER INTERACTION

LESS AFFECTED HAND IN UNILATERAL CEREBRAL PALSY

MOTOR LEARNING IN CHILDREN WITH UNILATERAL CEREBRAL PALSY