title: Mastery motivation: a way of understanding therapy outcomes for children with unilateral cerebral palsy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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: β = 0.03, p < 0.001), greater object-oriented persistence (DMQ: β = 0.31, p = 0.05), and treatment group allocation (Standard Care: β = 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.
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane , Australia .
authors.forename: Laura
authors.initials: L
authors.lastname: Miller
authors.forename: Jenny
authors.initials: J
authors.lastname: Ziviani
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
mesh_terms: D000293:Adolescent; D002170:Canada; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D006429:Hemiplegia; D006801:Humans; D008297:Male; D009042:Motivation; D009048:Motor Skills; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D010290:Parents; D026741:Physical Therapy Modalities; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Cerebral palsy; motivation; occupational performance; rehabilitation; upper limb