Prescribing upper limb orthoses for children with cerebral palsy: Exploring decision making and a hand deformity classification to guide orthosis prescription

Hand deformities in children with cerebral palsy (Co) result from an imbalance between wrist, finger and thumb musculature secondary to central neurological disturbances. Upper limb orthotic intervention aims to minimise muscular imbalance to improve function and/or prevent the progression of deformity form becoming fixed and painful. A lack of clarity in literature regarding upper limb orthosis prescription has led to insufficient evidence to support or refute the efficacy of this intervention. The paucity of evidence may result in part from difficulty researching a complex and multi-faceted intervention. This doctoral program aimed to explore clinicians' decision making when prescribing upper limb orthoses for children with CP, and investigate the validity and reliability of a hand deformity classification designed to aid clinical decision making.