Transforming Care for Children with Cerebral Palsy: The Spastic Hand Community Partnership

At Shriners Hospitals for Children Canada, innovation and collaboration drive our commitment to improving care for children with cerebral palsy (CP). The Spastic Hand Community Partnership (SHCP) is a shining example of this dedication, offering advanced support for children with upper limb spasticity across Quebec.

Founded in 2016 by Nathalie Bilodeau, a certified hand therapist and occupational therapist (OT) at Shriners Hospitals for Children Canada, the SHCP focuses on enhancing the assessment and non-surgical treatment of hand spasticity. The program empowers OTs to identify potential surgical candidates earlier and deliver personalized care that helps children achieve greater independence.

How It All Began

The SHCP started with a request from the Lethbridge-Layton-MacKay Rehabilitation Centre, which offers rehabilitation services for children and young adults, seeking training for their OTs on managing hand spasticity in children with CP. Nathalie, along with Chantal Janelle, M.D., FRCSC, an orthopedic surgeon at Shriners Hospitals for Children Canada, responded by creating an outreach clinic offering training and clinical support every two to three months.

This initiative introduced non-surgical treatments, including injections designed to reduce spasticity, helping muscles relax and improving movement. Along with splints, it also supported practitioners in refining their assessment techniques. The results were transformative, setting the stage for a growing program that continues to expand its reach."

Adapting Through Challenges

The SHCP adapted its outreach clinics during Covid to offer a virtual platform, enabling greater accessibility for OTs in regions beyond greater Montreal. Virtual clinics now connect practitioners from centers like the Jewish Rehabilitation Centre, CIUSSS du Saguenay−Lac-Saint-Jean, and CISSS Chaudière-Appalaches. These sessions include case presentations, knowledge-sharing, and hands-on patient assessments, ensuring children across Quebec benefit from advanced care.

“Children with CP and hand spasticity can improve independence in everyday activities like eating, dressing and writing, with the right interventions,” said Nathalie.

The Spastic Hand Clinic

In 2024, the demand for specialized care led to the establishment of the Spastic Hand Clinic at Shriners Hospitals for Children Canada. Led by Nathalie and Dr. Janelle, the clinic provides comprehensive evaluations and treatments, working closely with local OTs to explore both non-surgical and surgical options.

Building a Community of Care

Nathalie’s passion for pediatric hand therapy and spasticity care is the heart of the SHCP. “Hands are so complex, and spasticity adds another layer of complexity. But it’s this challenge that drives me,” said Bilodeau. “Hands are essential for everyday activities, and they deserve as much attention as the lower limbs.”

The SHCP has fostered a collaborative network of OTs across Quebec, creating a community where practitioners share knowledge, support each other and grow together. “This isn’t just about training – it’s about building a network of dedicated professionals who are improving care for children with CP,” Bilodeau added.

“We envision a future where specialized practitioners work together to provide consistent, high-quality care for children with CP. Plans for the coming year include expanding virtual clinics and involving more OTs from Shriners Hospitals for Children Canada,” Bilodeau said.

By strengthening this network and continuing to innovate, the SHCP is helping children with cerebral palsy achieve their fullest potential – one hand at a time.