Early developmental trajectories of the impaired hand in infants with unilateral cerebral palsy.

All 63 infants received early upper limb therapy, one of two kinds. There is no untreated group here, so this substudy cannot show that Baby-CIMT or Baby-BIM changed anything. The two treatments were not compared with each other in this analysis, and treatment type did not predict which pattern a child followed. The HAI is only validated up to 12 months of age, but a number of these infants were assessed as late as 15 months corrected age. The authors say it is unclear whether age at assessment affected the modelling. Each infant had only two or three hand assessments, and because they entered the study at different ages the timing of measurements could not be standardised. The authors list both as limitations. The cohort is small (63 infants) and drawn from a single trial, so the three groups and the links to sex and gestational age need confirming in other cohorts. The apparent dip in the highest-functioning group at the final assessment is unexplained; the authors say it is not simple to understand and needs further exploration. The finding that boys were more likely to be in the low group had wide confidence intervals, and the authors themselves say it should be viewed with caution and is somewhat inconsistent with the literature. Cognitive differences between groups at 12 to 15 months had disappeared by 24 months, and the authors say it is unclear whether or how cognition affects early two-handed play.

The only funding named in the supplied text is the National Health and Medical Research Council. No other funding source or conflict-of-interest declaration is included in the text provided.

Do not read this as a trial result. Every infant in this substudy received early upper limb therapy, so nothing here shows that Baby-CIMT or Baby-BIM works, and the study did not compare the two against each other. The finding is about how hand use developed in a treated group over time, not about which treatment to choose.