Action planning in typically and atypically developing children (unilateral cerebral palsy).
Eight weeks of CIMT paired with bimanual training teaches preschoolers with unilateral CP to open their hand on time before they grab.
01Research in Context
What this study did
The team worked with the preschoolers who have unilateral cerebral palsy. Half got eight weeks of constraint-induced movement therapy plus bimanual training. The other half were tested before any training.
Kids reached for toys while cameras tracked hand speed and grip size. The goal was to see if training helped them plan moves ahead of time.
What they found
Before training, kids with CP opened their hand too late or too little compared with same-age peers. After eight weeks, their grip timing and size looked much closer to typical levels.
The change showed up only in the trained, more-affected hand. Untrained kids stayed the same.
How this fits with other research
Bleyenheuft et al. (2013) reviewed 30 studies and found sensory loss is common in hemiplegic CP and hurts grip control. Céline’s trial adds proof that targeted practice can still fix the problem.
Ohan et al. (2015) saw poor hand-shaping in school-age kids even without training. Their negative result lines up with Céline’s pre-training scores and shows the deficit lasts if you do nothing.
Kretch (2026) notes infants at risk for CP spend less time in active positions. Starting CIMT plus bimanual work in the preschool years may close the gap those babies already show.
Why it matters
You can add a short CIMT block to your bimanual sessions and expect real gains in anticipatory planning. Track grip size with a simple video app; look for earlier, bigger hand openings as a quick win.
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02At a glance
03Original abstract
In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3-6 years, n=24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a wooden block. Our main dependent variable was the grip type that participants used, i.e., did they adapt their initial grip choice such that they would reach a comfortable posture at the end of the action? This end-state comfort effect has been abundantly shown in research on action planning, and is taken as evidence for anticipatory planning. The first aim of the study was to investigate the development of action planning in the unilateral CP group and the control group. Our hypothesis was that action planning improves with age in the control group, but not in the unilateral CP group. The results showed that planning was impaired in the unilateral CP group compared with the control group. Consistent with our hypothesis, we found an age effect in the control group, but not in the unilateral CP group. In the control group 5 and 6 years olds showed more anticipatory planning compared with the 3 and 4 years olds. The second aim of this study was to examine whether an intervention for children with unilateral CP (i.e., constrained induced movement therapy combined with bimanual training) affected action planning. The children with unilateral CP were therefore measured on the experimental task before and after an 8-week intervention period. The results showed that planning improved after the intervention. This finding suggests that action planning ability in young children with unilateral CP may be sensitive to improvement. These findings are discussed within the context of typical and atypical development of action planning and further guidelines for intervention in children with unilateral CP are given.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.04.007