Hand Function and Life Area Participation among the Children with Cerebral Palsy: A Cross-Sectional Study

Abstract

Background: Participation is a complex, context-dependent concept shaped by factors such as severity of CP, age, self-management abilities, and functional mobility. Children’s engagement in daily activities largely depends on these factors and varies widely. Hand function plays a critical role in determining their level of participation across life areas. Understanding this relationship is essential for designing comprehensive rehabilitation and supportive interventions. Aim: To find out the impact of hand function on Life Area Participation among Children with Cerebral Palsy. Methods: This cross-sectional quantitative study surveyed 102 school-going children with CP in Dhaka city and Savar using face-to-face interviews. Standardized tools, the Children Participation Questionnaire (CPQ) and the Manual Ability Classification System (MACS) were used to assess life areas participation and hand function. Data was analyzed using SPSS version 26 for both descriptive and inferential statistics. Result: The mean age of children with CP was 9.18±1.89 years, with most classified at MACS level II. Participation scores were diversity 42.51±4.85, intensity 121.08±33.27, with whom 168.29±38.85, enjoyment 185.84±31.85, and parent satisfaction 163.69±39.25. Children receiving more than three weekly therapy sessions had poorer hand function than those receiving fewer (P<.032), and quadriplegic CP showed the poorest hand function and participation (P<.001). All participation domains except “with whom’’ were negatively correlated with MACS level (P < .001), while the “with whom’’ domain showed a strong positive correlation (P < .001). Conclusion: Children with CP who attended three or fewer weekly therapy sessions demonstrated better hand function, while those with quadriplegic CP showed poorer performance. Upper extremity function was strongly linked to participation across life areas, especially parental satisfaction. Improving hand function, along with caregiver training and environmental support, can significantly enhance overall participation in children with CP. Keywords: Cerebral palsy; Manual ability; Life area participation; Occupations; Hand function.