Relationship Between Upper Limb Function and Participation in Hemiplegic cp

Children with HCP are faced with a variety of motor and sensory impairments that have an impact on their arm and hand functioning. Upper limb activity limitations reflect the difficulties experienced during reaching, grasping, manipulating and releasing objects with the hemiplegic arm and hand.

As a result, those children may choose to use their "less-affected" hand instead of the affected hand due to difficulties in using it . Although they can complete certain bimanual tasks primarily using one hand through compensatory strategies, the time required to accomplish these tasks is typically longer than their peers.

An important outcome of rehabilitation services is to optimize children's participation in different life situations such as home, school and in the community .Participation in family and recreational activities provides avenues for children to play, learn skills, make friends and develop self-confidence and belonging. Understanding the link between manual ability and participation is essential in pediatric rehabilitation for children with HCP. Adequate assessment of upper limb function in those children is crucial not only to outline treatment, but also to measure the efficacy of their participation in life areas activities and to allow follow-up over time.

This study highlights how limitations in upper limb manual ability can restrict participation in life areas activities of those children, so it can guide goal-setting in both occupational therapy and physical therapy, emphasizing activities that promote both hand function and participation in life areas activities. Simultaneously this study supports the movement of the growing trend in family-centered and participation-focused therapy.

Inclusion criteria

• Children diagnosed with hemiplegic cerebral palsy.
• Both genders will be included.
• Children's age will be ranging from 5 to 8 years.
• The degree of spasticity in affected upper limb ranges from grade 1, 1+ and 2 according to Modified Ashworth Scale.
• Children are able to understand and respond to simple instructions.
• Children in inclusion education system.
• Parents are of nearly the same socioeconomic level and must have at least an average level of education.

Exclusion criteria

• Children will be excluded in the presence of the following:

• Severe visual, auditory or perceptual impairment that interfere with the evaluation program.
• Botulinum toxin injection in upper limb or recent orthopedic surgery within last 6 months (Alkan and Bingol,2021).
• Fixed deformities in the affected upper limb. Significant mental or psychological problems that interfere with understanding instructions.