This retrospective single-center study aims to describe the care pathways of children with unilateral cerebral palsy (hemiplegia) who participated in intensive therapy programs (COLHEMI and/or Mini-COLHEMI) at the Centre des Massues since January 2010. The COLHEMI program (launched in 2010, for children aged 6-12) provides 70 hours of intensive motor learning-based therapy over 2 weeks, while the Mini-COLHEMI program (launched in 2020, for children from age 2) provides 30 hours over 2 weeks. The study will describe the immediate and medium-term impact of these programs on bimanual performance (Assisting Hand Assessment, AHA) and individualized goal attainment (Goal Attainment Scaling, GAS), analyze their impact on bimanual developmental trajectories using all available AHA scores, identify characteristics of good responders, and describe parent satisfaction. Approximately 75 patients will be included. Data are collected retrospectively from electronic and paper medical records by an occupational therapist.
Minor patient (age < 18 years)
Unilateral upper limb involvement due to Cerebral Palsy (hemiplegia)
Having participated in at least one intensive therapy program (COLHEMI and/or Mini-COLHEMI) since program launch in January 2010
Participation before June 30, 2026
None
Children with unilateral cerebral palsy (hemiplegia) who participated in at least one COLHEMI or Mini-COLHEMI intensive therapy program at the Centre Médico-Chirurgical de Réadaptation des Massues between January 2010 and June 2026, with available pre- and post-program functional assessments in their medical records.
Cohort
Retrospective
COLHEMI program
Other interventionthe COLHEMI program (for children aged 6-12 years; 70 hours of motor learning-based intensive therapy over 2 weeks combining mCIMT, bimanual training, and goal-oriented therapy) and/or the Mini-COLHEMI program (for children from age 2; 30 hours over 2 weeks of 10 half-day sessions)
Structured Description of Care Pathway Including Intensive Therapy
Structured description of each patient's care pathway, integrating: type (COLHEMI or Mini-COLHEMI) and number of intensive therapy sessions attended; associated medical treatments (botulinum toxin injections - nature, muscles targeted, and timing relative to each intensive therapy episode); associated surgical treatments (nature and timing relative to each intensive therapy episode); and type of regular rehabilitation follow-up (private practice, medico-social, health institution).
Immediate Impact on Bimanual Performance - Assisting Hand Assessment (AHA)
Change in AHA score (version 5.0) between the pre-therapy assessment (within 3 months before program start) and the immediate post-therapy assessment (within 1 month after program end). The AHA evaluates the effectiveness of the assisting hand in bimanual performance in children aged 18 months to 18 years, scored on an interval scale from 0 to 100 AHA units. A difference of 5 AHA units is considered clinically significant. Inter-rater reliability: ICC = 0.98.
Immediate Goal Attainment - Goal Attainment Scaling (GAS)
GAS scores immediately after each intensive therapy episode. Goal Attainment Scales are 5-level ordinal scales where -2 = baseline level, -1 = some progress below expected, 0 = expected level reached, +1 = slightly above expected, +2 = best possible outcome. Goals are individually defined and operationalized before each intensive therapy program based on the child's activity limitations in daily life. The proportion of patients reaching or exceeding their goal (score ≥ 0) is calculated for each goal and overall.
Medium-Term Goal Attainment - Goal Attainment Scaling (GAS) at 3 Months
GAS scores at 3 months after each intensive therapy episode, using the same individualized goals defined before the program. A score ≥ 0 indicates that the expected level has been maintained or exceeded at 3 months. Comparison with immediate post-therapy GAS scores assesses maintenance of gains.
Impact on Bimanual Developmental Trajectory - Longitudinal AHA Scores
All AHA scores available in each patient's medical record are collected to model bimanual performance developmental trajectories. A linear mixed model (LMM) is applied with age as a fixed effect (natural maturation), COLHEMI/Mini-COLHEMI participation as an intervention variable, and random effects for individual baseline and rate of progression, to determine whether intensive therapy episodes induce a significant shift in performance level or progression rate relative to spontaneous development.
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