Effectiveness of Play-Based Nursing Interventions on Hand Function in Children with Cerebral Palsy: A Quasi-Experimental Study
DOI:
https://doi.org/10.31674/mjn.2025.v17i02.015Abstract
Background: Traditional nursing interventions for children with Cerebral Palsy (CP) often lack active engagement and show limited improvement in motor function. Play interventions involving manipulative activities may better support motor skill development. Objectives: To evaluate the effect of structured play-based nursing interventions on hand motor skills in children with cerebral palsy. Methods: A quasi-experimental pre-test/post-test design with a control group was used. The study was conducted at the Paediatric Welfare Hospital in Baghdad from November 25, 2024, to February 13, 2025. A non-probability sample of 79 children was identified based on the study criteria; of these, 64 children met the eligibility criteria and agreed to participate. While all children continued routine care, only intervention groups received play-based therapy using clay, beads, and sand. The Box and Block Test (BBT) was used to assess hand function before and after the intervention. Data were analysed using SPSS (version 0.27) with descriptive and inferential statistics. Results: The intervention groups demonstrated significant improvements in hand function compared to the control group (ANOVA: F = 8.11, p = 0.001, η² = 0.29), reflecting a medium-to-large effect size. Analysis across time points showed that at post-test 1, the effect size was medium (η² = 0.17), whereas at post-test 2, it increased to medium-to-large (η² = 0.29). Post-hoc comparisons indicated that the clay intervention produced the largest gains in Box and Block Test scores (Cohen’s d = 0.65, medium effect), while sand therapy resulted in moderate improvements and bead therapy showed smaller gains. Overall, the percentage improvement in hand function ranged from 18% to 27% across intervention groups. Conclusion: Nursing interventions incorporating play activities are effective in improving hand function in children with cerebral palsy. These methods are child-friendly, supporting the development of motor skills and promoting greater independence. However, no follow-up assessments were conducted to evaluate the long-term sustainability of improvements. Future studies should include follow-up evaluations to confirm lasting benefits.
Keywords:
Cerebral Palsy, Hand Function, Nursing Programme, Play TherapyDownloads
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