Article

PURPOSE: To investigate the impact of mastery motivation on occupational
performance outcomes immediately following upper limb (UL) training and 6 months
post-intervention for school-aged children with unilateral cerebral palsy.
METHOD: This prediction study was a post-hoc analysis of a matched pairs
randomized comparison trial (COMBiT Trial Registration: ACTRN12613000181707).
The Canadian Occupational Performance Measure (COPM) was administered at baseline, 13
and 26 weeks post-intervention. Parents completed the Dimensions of Mastery
Questionnaire (DMQ), Parenting Scale and a demographic questionnaire. Children's
UL capacity and performance was assessed using the Melbourne Assessment of
Unilateral UL Function and assisting hand assessment (AHA). Regression models
were fitted using generalized estimating equations to baseline, 13 and 26 week
measurements. RESULTS: Forty-six children (7.78 years SD 2.27 years, 31 males,
Manual Ability Classification System I = 23, II = 23) participated. Higher levels
of bimanual performance (AHA: beta = 0.03, p < 0.001), greater object-oriented
persistence (DMQ: beta = 0.31, p = 0.05), and treatment group allocation
(Standard Care: beta = 0.24, p = 0.01) were positively associated with COPM
performance scores post-intervention. CONCLUSIONS: Children's bimanual
performance and persistence with object-oriented tasks significantly impact
occupational performance outcomes following UL training. Predetermining
children's mastery motivation along with bimanual ability may assist in tailoring
of intervention strategies and models of service delivery to improve
effectiveness. Implications for Rehabilitation Children's object persistence and
bimanual performance both impact upper limb training outcomes Working with
children's motivational predispositions may optimize engagement and therapy
outcomes. Supporting positive parenting styles may enhance a child's mastery
motivation and persistence with difficult tasks.

Langue : ANGLAIS