Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years.

The study used a convenience sample recruited from habilitation centers and hospitals, which likely included children with more severe impairments and excluded those with mild impairments who had minimal contact with services. The number of assessments varied widely between children (range 2–16), and older age groups had fewer participants, making estimates for adolescents less reliable. Interventions such as constraint-induced movement therapy, hand surgery, and botulinum toxin were common among participants but were not controlled for in the statistical models, so it is unclear how these treatments influenced the observed trajectories. The findings may not generalize to populations with different access to habilitation services or different geographical contexts.

Funding was provided by Norrbacka-Eugeniastiftelsen, Stiftelsen Frimurare Barnhuset i Stockholm, Stockholm City Council, and the Swedish Research Council. No conflicts of interest were declared.

Do not assume that hand function remains stable for every individual. While the group averages showed stability from age 7, the study found large individual variation, meaning some children may improve or decline. Regular clinical follow-up is necessary to detect these individual changes.