Occupational therapy home programmes for children with unilateral cerebral palsy using bimanual and modified constraint induced movement therapies: A critical review

Introduction: The home context is considered a good location for children with cerebral palsy to practise meaningful occupations.
The aim of this critical review was to gain a deeper understanding of how bimanual therapy and modified constraint induced
movement therapy or constraint induced movement therapy methods are used within occupational therapy home programmes
from an occupational perspective.
Method: A literature search was conducted using electronic databases for health research; five studies met the inclusion criteria.
These were critically appraised and were analysed according to the relevant supports and barriers of the person–environment–
occupation conceptual model of practice.
Findings: Family collaboration, strategic use of outcome measures, construction of the programme within the home environment
and occupation-focused goals and activities emerged as commonly used methods. Enhanced descriptions of intervention context,
the child’s voice in defining goals and challenges in optimising occupational balance surfaced as gaps in the programmes.
Conclusion: The methods used in implementing these approaches within occupational therapy home programmes requires
combining motor and non-motor approaches, core occupational therapy skills, working within individual contexts and valuing
family preferences. Using child-specific goal-setting instruments would strengthen the child’s voice and promote participation
within a wider range of occupations.