Enhancing Function and Quality of Life: Occupational Therapy in Cerebral Palsy Neurology, Psychiatry, Physical medicine

Background and Objective Cerebral palsy (CP) is the most common cause of childhood physical disability worldwide, with heterogeneous motor and functional challenges. Occupational therapy (OT) plays a pivotal role in enhancing activity and participation. This abstract summarizes the latest evidence (۲۰۱۹-۲۰۲۵) on effective OT interventions for children with CP, emphasizing clinically relevant principles for practice. Methods A targeted review of randomized controlled trials (RCTs), multicenter studies, and systematic reviews was conducted across major databases. Interventions were clustered into: (۱) intensive task-specific practice (e.g., CIMT, bimanual training such as HABIT/HABIT-ILE), (۲) cognitive strategy-based approaches (CO-OP, goal-directed training), (۳) technology-assisted programs (virtual reality, robotics, assistive devices), and (۴) home-based and telehealth delivery. Outcomes were mapped to the International Classification of Functioning, Disability and Health (ICF). Results Constraint-Induced Movement Therapy (CIMT) shows strong evidence for improving upper limb function in children with hemiplegic CP, although effect sizes vary across contexts. Bimanual intensive training (HABIT/HABIT-ILE) demonstrates robust improvements in upper limb, trunk control, and participation across multiple RCTs and systematic reviews. Cognitive Orientation to daily Occupational Performance (CO-OP) and goal-directed training enhance achievement of child/family-selected goals, with evidence for transfer to novel tasks. Technology-assisted interventions (VR, robotics) provide small-to-moderate functional gains and caregiver burden reduction, though evidence remains heterogeneous. Dose matters: cumulative practice of \۳۰-۴۰ hours appears to be a threshold for clinically meaningful change. Positive effects on participation outcomes are emerging, but evidence is weaker compared to activity-level measures and requires standardized tools. Conclusions and Implications Effective OT for CP should prioritize intensive, task-specific practice and cognitive strategy training, guided by family-centered goals and a sufficient therapeutic dose. Technology-based interventions can complement conventional therapy, particularly for motivation and access. Future research should address participation-level outcomes, dose-response relationships across age and CP subtypes, and implementation in low-resource settings.

کلیدواژه ها:

Cerebral palsy ، occupational therapy ، ICF