Development of bimanual performance in young children with cerebral palsy

Abstract

Manual Ability Classification System levels and Assisting Hand Assessment/Both Hands Assessment performance at 18 months are important predictors of hand use development in cerebral palsy (CP). Children with bilateral CP improved less than those with unilateral CP. Children with bilateral CP and symmetric hand use reached higher limits than those with asymmetry.

Reliability and responsiveness of the Jebsen‐Taylor Test of Hand Function and the Box and Block Test for children with cerebral palsy

“…34 Conversely, two studies observing outcomes in bimanual performance in children with unilateral and bilateral impairments assessed with the Assisting Hand Assessment and the Both Hands Assessment 32,35 showed similar results in both groups. Although our results on the responsiveness are similar between both groups (improvement after intervention), the mean values at each assessment differed between groups, showing the specificity of each topography.…”

“…Such differences between children with unilateral and bilateral CP have been also observed when children with CP where classified with the Bimanual Fine Motor Function. 34 Conversely, two studies observing outcomes in bimanual performance in children with unilateral and bilateral impairments assessed with the Assisting Hand Assessment and the Both Hands Assessment 32,35 showed similar results in both groups.…”

“…32,33 Children in MACS level III may have a lower performance in these tests on both hands, therefore improvements in both hands can be targeted. However, the MACS level I group presented a large change on the more affected hand when compared with the other MACS levels, while the MACS level III group presented a large difference on the less affected hand for this test when compared with the other MACS levels.…”

“…Moreover, these children reach the maximal predicted improvement of bimanual performance faster than children classified in MACS levels II and III. 32,33 Children in MACS level III may have a lower performance in these tests on both hands, therefore improvements in both hands can be targeted. These results are congruent with those of MCIDs.…”

Promoting optimal bimanual performance in cerebral palsy

“…Bimanual performance is the term used to describe how we spontaneously use our two hands in activity. Klevberg et al . examined the development of bimanual performance in a Norwegian population of young children with cerebral palsy (CP).…”