ACTIVITIES OF DAILY LIVING IN CHILDREN: THEORETICAL PERSPECTIVES IN OCCUPATIONAL THERAPY

Abstract

Background: Cerebral palsy (CP) is a leading cause of childhood disability, affecting 1 in 500 newborns globally.Hemiparesis, a common form of CP, limits upper limb function and impacts activities of daily living (ADL). Constraint- induced movement therapy (CIMT) is a proven intervention for improving motor function, promoting greater independence.This study evaluates the effectiveness of modified CIMT (mCIMT) in enhancing hand function and ADL performance in children with unilateral CP.Methods: A systematic review was conducted to analyze mCIMT protocols, focusing on therapy duration, immobilization methods, and age-related outcomes. Key indicators assessed included motor improvements, ADL proficiency, and quality of life.Results: mCIMT significantly improves ADL performance, enhancing self-care skills, grasping function, and bimanual coordination. Recent studies (e.g., Tanabe et al., 2025; Reidy et al., 2023) show notable gains in PDMS-2, PEDI, and PMAL scores (p < 0.01) in children 6–8 years old, with a threefold increase in affected hand use. Hybrid and home-based CIMT models demonstrate comparable efficacy to clinic-based interventions, improving therapy accessibility.Discussion: Research suggests that mCIMT, especially when combined with bimanual training, leads to superior outcomes. Higher therapy doses and shaping techniques are particularly beneficial for older children. Task-oriented and engaging rehabilitation strategies enhance participation and motivation, maximizing treatment benefits.Conclusion: mCIMT is a highly effective rehabilitation method, improving ADL, upper limb function, and independence in children with CP. Further research is needed to standardize intervention protocols and explore long-term effects, ensuring sustained improvements and broader therapy accessibility.