The treatment of children with cerebral palsy with Botulinum toxin A injections is well established, safe and effective. However, a standardized injection strategy is still missing and the used dosage has escalated over the years. In the recent past, the recommended dosages in Europe were, however, reduced due to a better understanding of the relationship between dosage, severe side effects and the kind of anesthesia used. To combine safety and efficacy, the trend tends to a lower dosage, but combined with a more specific selection of injected muscles. The treatment of these key-muscles takes into account the best support for motor development to attain each individual motor milestone.

Children with unilateral cerebral palsy (CCP) benefit from intensive training with the affected side. The SHArKi project strives for a motivational support system, using wristbands with inertial measurements units (IMU) to measure arm function, providing biofeedback as well as motivating stimuli. To consider finger and wrist movements as well, this paper covers concepts for a tangible solution and its first implementation including the gamification development. Finalizations of the demonstrator, an overall functional test as well as concluding feedback from CCP are pending.