Age-related differences in behavioral outcomes of bimanual functional motor tasks in children and adolescents with cerebral palsy: a scoping review

The objective of this review is to determine age-related differences in behavioral outcomes of bimanual motor tasks in children and adolescents with cerebral palsy (CP). This review followed the 6-stage Joanna Briggs Institute methodology. The Embase, EBSCO CINAHL, and PubMed databases were searched on May 2024. We included studies that employed instrumented measures to assess bimanual tasks in individuals with CP aged between 3 and 19 years. Twenty-eight studies were included after full-text screening. This review reported on 544 individuals with CP. Bimanual tasks were grouped in seven categories and their varying complexities were listed and analyzed. There are numerous methods for assessing bimanual performance. The listed methods have shown that the gap between children with CP and healthy peers widens as task complexity increases. The data suggest that age-related outcomes result from a complex interaction between atypical development, the severity of deficits, and the context-dependent nature of the protocols. The lack of standardized reporting on age-related results limits our understanding of bimanual developmental functions in CP. Standardizing these measures will enhance our understanding of bimanual function and better define the principles guiding therapeutic interventions, ultimately improving outcomes for individuals with CP. In studies with children and adolescents with cerebral palsy, seven categories of instrumented bimanual tasks were identified.Rehabilitation professionals should prioritize precise, adaptable tools to track subtle patient progress.Providing children and adolescents with cerebral palsy with tasks of different complexities could assist them in accomplishing activities of daily living.Rehabilitation interventions should be tailored to each patient’s developmental level and clinical profile. In studies with children and adolescents with cerebral palsy, seven categories of instrumented bimanual tasks were identified. Rehabilitation professionals should prioritize precise, adaptable tools to track subtle patient progress. Providing children and adolescents with cerebral palsy with tasks of different complexities could assist them in accomplishing activities of daily living. Rehabilitation interventions should be tailored to each patient’s developmental level and clinical profile.

本综述旨在明确脑性瘫痪（cerebral palsy, CP）儿童与青少年完成双侧运动任务时的行为结局与年龄相关的差异。本综述遵循乔安娜·布里格斯研究所（Joanna Briggs Institute）的6阶段方法学流程。本研究于2024年5月检索了Embase、EBSCO CINAHL及PubMed数据库。纳入标准为采用仪器化评估方法测评3至19岁脑性瘫痪患者双侧运动任务表现的研究。经全文筛查后，最终纳入28项研究，共涉及544名脑性瘫痪患者。本综述将双侧运动任务划分为7大类，并对其不同复杂度等级进行了梳理与分析。当前用于评估双侧运动表现的方法多种多样，现有研究结果显示，随着任务复杂度提升，脑性瘫痪儿童与健康同龄儿童的表现差距会逐渐扩大。数据表明，年龄相关的行为结局是由非典型发育、缺损严重程度以及测评方案的情境依赖性三者之间的复杂交互作用所导致。目前针对年龄相关结果的标准化报告机制缺失，限制了我们对脑性瘫痪患者双侧运动发育功能的认知。统一此类测评标准将有助于深化对双侧运动功能的理解，更好地明确指导康复干预的核心原则，最终改善脑性瘫痪患者的预后结局。在针对脑性瘫痪儿童及青少年的研究中，共识别出7大类仪器化双侧运动任务。康复从业者应优先选用精准且适配性强的工具，以追踪患者细微的康复进展。为脑性瘫痪儿童及青少年提供不同复杂度的任务，可助力其完成日常活动。康复干预方案应结合每位患者的发育水平与临床特征进行个体化定制。在针对脑性瘫痪儿童及青少年的研究中，共识别出7大类仪器化双侧运动任务。康复从业者应优先选用精准且适配性强的工具，以追踪患者细微的康复进展。为脑性瘫痪儿童及青少年提供不同复杂度的任务，可助力其完成日常活动。康复干预方案应结合每位患者的发育水平与临床特征进行个体化定制。