Activity and Participation in Adolescents With Hemiplegic Cerebral Palsy: The Role of Upper Extremity Dexterity and Proprioception Within the ICF Framework

Aim: This study aimed to compare bilateral upper extremity proprioception and functional skills in adolescents with hemiplegic Cerebral Palsy (CP) and typically developing peers, and to examine their associations with activity and participation within the ICF framework. Methods: Thirty-eight participants were included (19 adolescents with hemiplegic CP and 19 typically developing peers). Proprioception (kinesthesia and joint position error) was assessed for both upper extremities, and functional performance was evaluated using the Gross Motor Function Measure-66, Jebson Taylor Hand Function Test (JTHFT), ABILHAND-Kids, and Pediatric Evaluation of Disability Inventory (PEDI). Group differences were analyzed using ANCOVA with age as a covariate. Results: Adolescents with hemiplegic CP demonstrated significantly lower gross motor function, kinesthesia, affected-side joint position accuracy, upper extremity dexterity, activity, and participation levels compared with their peers ( p < .01). Moderate positive correlations were found between PEDI domains, JTHFT, and ABILHAND-Kids ( p < .05), as well as between kinesthesia and JTHFT ( p < .01). Discussion: The findings suggest that adolescents with hemiplegic CP may have lower levels of proprioception on both sides, gross motor function, and activity and participation compared to their typically developing peers. This study is considered to provide a comparative evaluation of bilateral proprioception in adolescents with hemiplegic CP and to highlight its associations with functional performance, activity, and participation.