Authors : Wanbiang Daka Nanghuloo; Chinduja S.; Dr. B. S. Santhosh Kanna

Volume/Issue : Volume 11 - 2026, Issue 9 - September

Google Scholar : https://tinyurl.com/yabtc5zx

DOI : https://doi.org/10.38124/ijisrt/26sep969

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background: Hemiplegic cerebral palsy is a unilateral form of cerebral palsy characterized by persistent impairment of movement and posture affecting one side of the body, with the upper limb often being more functionally affected than the lower limb. Impairments in grasping ability, hand coordination, dexterity, and the functional use of the affected upper limb may limit a child’s ability to perform activities of daily living independently. Among the rehabilitation strategies used to address these difficulties are Task-Oriented Training and Mirror Therapy, which aim to facilitate improvements in hand and upper-limb function in children with hemiplegic cerebral palsy.  Aim: To compare the effects of Task-Oriented Training and Mirror Therapy on hand function in children with hemiplegic cerebral palsy.  Method: An experimental pre-test and post-test design was used to examine the effects of the two rehabilitation interventions in six children with hemiplegic cerebral palsy between 7 and 16 years of age. The participants were randomly allocated into two groups, consisting of three children each. Participants in Group A underwent Task-Oriented Training, whereas Group B received Mirror Therapy. Each intervention session lasted approximately 30–45 minutes and was conducted three times per week over a 12-week period. Hand function was evaluated using the Quality of Upper Extremity Skills Test (QUEST), while grip strength was assessed with a hand dynamometer. Measurements obtained before and after the intervention were subsequently recorded and compared.  Results: Improvements in hand function and grip strength were observed in both intervention groups following the 12-week training period. The mean change in QUEST scores was 7 points in Group A and 12 points in Group B. Similarly, mean grip strength increased by 1.5 kg in Group A and 2.16 kg in Group B. The observed changes were greater in the Mirror Therapy group for both outcome measures.  Conclusion: Both Task-Oriented Training and Mirror Therapy were associated with improvements in hand function and grip strength among children with hemiplegic cerebral palsy. The changes observed in QUEST scores and hand dynamometer measurements were greater in the Mirror Therapy group than in the Task-Oriented Training group. However, these findings should be interpreted cautiously because of the small sample size and limited duration of the intervention.

Keywords : Cerebral Palsy, Hemiplegic Cerebral Palsy, Task-Oriented Training, Mirror Therapy, Hand Function, QUEST, Hand Dynamometer, Grip Strength.

References :

1. Krigger, K. W. (2006). Cerebral palsy: an overview. American family physician, 73(1), 91-100.
2. Vitrikas, K., Dalton, H., & Breish, D. (2020). Cerebral palsy: an overview. American family physician, 101(4), 213-220.
3. Oskoui, M., Coutinho, F., Dykeman, J., Jetté, N., & Pringsheim, T. (2013). An update on the prevalence of cerebral palsy: a systematic review and meta‐analysis. Developmental Medicine & Child Neurology, 55(6), 509-519.
4. Arnould C, Bleyenheuft Y and Thonnard J-L (2014) Hand Functioning in Children with Cerebral Palsy. Front. Neurol. 5:48. doi: 10.3389/fneur.2014.00048
5. Gordon, A. M., Bleyenheuft, Y., & Steenbergen, B. (2013). Pathophysiology of impaired hand function in children with unilateral cerebral palsy. Developmental Medicine & Child Neurology, 55, 32-37.
6. Makki, D., Duodu, J., & Nixon, M. (2014). Prevalence and pattern of upper limb involvement in cerebral palsy. Journal of children's orthopaedics, 8(3), 215-219.
7. Halford, E., Jakubiszak, S., Krug, K., & Umphress, A. (2024). What is task-oriented training? a scoping review. Student Journal of Occupational Therapy, 4(1), 1-23.
8. Moon, J. H., Jung, J. H., Hahm, S. C., & Cho, H. Y. (2017). The effects of task-oriented training on hand dexterity and strength in children with spastic hemiplegic cerebral palsy: A preliminary study. Journal of physical therapy science, 29(10), 1800-1802.
9. Madeshwaran, S. (2024). A Study on the Effectiveness of Task Oriented Strength Training to Enhance Upper Limb Motor Function in Children with Cerebral Palsy. Indian Journal of Physiotherapy & Occupational Therapy, 18.
10. Gbonjubola, Y. T., Muhammad, D. G., & Elisha, A. T. (2021). Physiotherapy management of children with cerebral palsy. Adesh University Journal of Medical Sciences & Research, 3(2), 64-68.
11. Xiao Y, Zhang J, Liu Y, Chen X, Wu R, Le S, Fan W, Zhao L and Gao F (2026) The impact of task-oriented training on hand functionality in children with cerebral palsy under 18 years: a systematic review and meta-analysis. Front. Neurol. 17:1775810. doi: 10.3389/fneur.2026.1775810
12. Narimani, A., Kalantari, M., Dalvand, H., & Tabatabaee, S. M. (2019). Effect of mirror therapy on dexterity and hand grasp in children aged 9-14 years with hemiplegic cerebral palsy. Iranian journal of child neurology, 13(4), 135.
13. Kara, O. K., Yardimci, B. N., Sahin, S., Orhan, C., Livanelioglu, A., & Soylu, A. R. (2020). Combined effects of mirror therapy and exercises on the upper extremities in children with unilateral cerebral palsy: a randomized controlled trial. Developmental neurorehabilitation, 23(4), 253-264.
14. Park, E. J., Baek, S. H., & Park, S. (2016). Systematic review of the effects of mirror therapy in children with cerebral palsy. Journal of physical therapy science, 28(11), 3227-3231.
15. Gygax, M. J., Schneider, P., & Newman, C. J. (2011). Mirror therapy in children with hemiplegia: a pilot study. Developmental Medicine & Child Neurology, 53(5), 473-476.
16. Bhasin, A., Srivastava, M. P., Kumaran, S. S., Bhatia, R., & Mohanty, S. (2012). Neural interface of mirror therapy in chronic stroke patients: a functional magnetic resonance imaging study. Neurology India, 60(6), 570-576.
17. Dohle, C., Püllen, J., Nakaten, A., Küst, J., Rietz, C., & Karbe, H. (2009). Mirror therapy promotes recovery from severe hemiparesis: a randomized controlled trial. Neurorehabilitation and neural repair, 23(3), 209-217.
18. Deconinck, F. J., Smorenburg, A. R., Benham, A., Ledebt, A., Feltham, M. G., & Savelsbergh, G. J. (2015). Reflections on mirror therapy: a systematic review of the effect of mirror visual feedback on the brain. Neurorehabilitation and neural repair, 29(4), 349-361.
19. Thorley, M., Lannin, N., Cusick, A., Novak, I., & Boyd, R. (2012). Construct validity of the Quality of Upper Extremity Skills Test for children with cerebral palsy. Developmental Medicine & Child Neurology, 54(11), 1037-1043.
20. Klingels, K., De Cock, P., Desloovere, K., Huenaerts, C., Molenaers, G., Van Nuland, I., ... & Feys, H. (2008). Comparison of the Melbourne assessment of unilateral upper limb function and the quality of upper extremity skills test in hemiplegic CP. Developmental Medicine & Child Neurology, 50(12), 904-909.
21. Le-Ngoc, L., & Janssen, J. (2012). Validity and reliability of a hand-held dynamometer for dynamic muscle strength assessment. Rehabil Med, 4, 53-66.
22. Yodchaisarn, W., Suriyaamarit, D., & Udom, C. (2023). Immediate Effect of Mirror Therapy Using Pegboard Training on Hand Function and Muscle Activities in Individuals with Asymmetrical Hand Function. Iranian Rehabilitation Journal, 21(2), 263-272.