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Fifteen-minute consultation: Management of the upper limb in unilateral cerebral palsy
  1. Jill Cadwgan1,2,
  2. Janice Pearse3,
  3. Anita Devlin2,4,
  4. Anna Basu4,5
  1. 1 Paediatric Neurosciences, Evelina London Children’s Hospital, Guys and St Thomas' NHS Foundation Trust (Kings Health Partners), London, UK
  2. 2 Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
  3. 3 Therapy Services, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  4. 4 Paediatric Neurology, Great North Children’s Hospital, Newcastle upon Tyne, UK
  5. 5 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Jill Cadwgan, Evelina London Children’s Hospital, St Thomas’ Hospital, London SE1 7EH, UK; J.E.Kisler{at}ncl.ac.uk

Abstract

Children with unilateral cerebral palsy (UCP) have complex health, education and social care needs. Delayed gross motor milestones are the most common presenting feature, and much of the early management focuses on gross motor skills and lower limb management. In later childhood, adolescence and adulthood, upper limb function has significant impact on activity, participation and independence. There is clear pathophysiological rationale and emerging clinical evidence that earlier intervention to improve upper limb function is beneficial. Whereas most children with UCP are managed in secondary care, it is recommended that the assessment and delivery of specialist intervention for the upper limb occurs at a regional centre.

  • comm child health
  • general paediatrics
  • multidisciplinary team-care
  • neurodevelopment
  • neurodisability
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Footnotes

  • Contributors JC drafted the initial article. All authors significantly contributed to the content and have worked on all subsequent drafts to develop the final manuscipt. JP also drafted table 3 (assessments). All authors have agreed on the content of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed in this publication are those of the author and not necessarily those of the NHS, the National Institute for Health Research, or the Department of Health.

  • Competing interests JC has received personal honoraria for delivery of teaching and development of training materials from Ipsen Pharmaceuticals. JC has received funding for an alternative study regarding postural management in cerebral palsy from the National Institute for Health Research. AB is funded by a Career Development Fellowship award from the National Institute for Health Research. AB has received funding from Ipsen to develop educational materials around early detection of abnormal movements in infants. JP has also worked on this study.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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