Upper Limb Training Dosage and Functional Improvements

Do you work with children who have cerebral palsy? Recent research on upper limb training dosage and functional improvements was published in the Australian Occupational Therapy Journal.

This research review was conducted to quantify which rehabilitation training approaches and doses results in the largest clinically significant functional improvements.

Results of the Study

This systematic review included 74 randomized controlled trial studies with children (0-18 years old) with cerebral palsy or brain injury where the main intervention was an active upper limb training intervention.

The results indicated the following:

approximately 40 hours of practice is need to improve upper limb motor ability in children with unilateral cerebral palsy.
for all types of cerebral palsy, individual goals were acheived after 14-25 hours of practice when goal directed interventions were provided.

Conclusion

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.
general upper limb function in children with unilateral cerebral palsy, they need to practice for more than 30–40 hr.
goal achievement, interventions that set functional goals and involve actual practice of those goals lead to goal achievement at a lower dose than general upper limb motor training.

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, 67(3), 269-280.

Resources to Help

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.