Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. I: Anticipatory scaling

Gordon, Andrew; Duff, Susan V.

doi:10.1111/j.1469-8749.1999.tb00576.x

Cited by 56 publications

(64 citation statements)

References 31 publications

(28 reference statements)

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“…Children were instructed to grasp the object between the thumb and the index finger ("precision grip") and lift it so that it was adjacent to a marker 5 cm high. They often used their middle finger against the index finger nail for additional support ("three-digit pinch") and/or lifted the instrument between the thumb and lateral portion of their index finger ("lateral pinch") when using their "involved" hand, which we have shown does not affect the use of anticipatory force scaling (7).…”

Section: Methodsmentioning

confidence: 76%

“…In agreement with earlier studies, children with hemiplegic CP use a default force scaling in their involved hand, regardless of object weight (6 -8), suggesting impaired anticipatory force control. However, with enough practice, children with CP can learn to differentiate the force scaling according to object weight (7,8), indicating that the lack of anticipatory scaling in other studies was not due to an inability to graduate the force output (i.e. an impairment in motor execution).…”

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confidence: 86%

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Fingertip Force Planning During Grasp Is Disrupted by Impaired Sensorimotor Integration in Children With Hemiplegic Cerebral Palsy

2006

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ABSTRACT:In the present study we examine the ability of children with hemiplegic cerebral palsy (CP) to use anticipatory control of fingertip forces during grasping, and whether anticipatory control is facilitated by lifts with the contralateral hand. Eight children with CP (age 4 -13) were asked to perform several lifts of either a 250-g or 500-g object instrumented with force transducers with one hand, followed immediately by several lifts with the contralateral hand. This was repeated for each combination of weight and starting (involved or non-involved) hand. Similar to previous studies, the rate of load force development showed impaired anticipatory control during lifts with the involved hand, intact anticipatory control in the non-involved hand, and transfer of anticipatory control from the non-involved to the involved hand. Surprisingly, however, we also found a transfer from the involved hand to the non-involved hand. The results suggest that the impaired anticipatory control in the involved hand is not purely a sensory or motor problem, and instead is due to an inability to appropriately integrate sensory information with subsequent motor output of the same hand. These results provide important information about the mechanisms underlying impaired anticipatory control, and may have important clinical implications. (Pediatr Res 60: 587-591, 2006)

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Section: Methodsmentioning

confidence: 76%

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confidence: 86%

Fingertip Force Planning During Grasp Is Disrupted by Impaired Sensorimotor Integration in Children With Hemiplegic Cerebral Palsy

2006

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“…1,24,26 The criteria included (1) the ability to extend the wrist Ն20°and the metacarpophalangeal joint 10°from full flexion, 32 (2) a 50% difference between the involved and noninvolved hand on the Jebsen-Taylor Test of Hand Function, 33 (3) a score within 1 SD from the mean on the Kaufman Brief Intelligence Test, 34 and (4) willingness to agree to intervention and testing procedures and travel to the university for participation. Children were excluded who had (1) any health problems that are not associated with CP, (2) seizures, (3) visual problems that would prevent them from carrying out the intervention or testing tasks, (4) severe muscle tone (Modified Ashworth score of Ͼ3), (5) orthopedic surgery on their more affected upper extremity, (6) experienced a dorsal rhizotomy, (7) received botulinum toxin therapy in the upper-extremity musculature during the last 6 months or who wish to receive it within the period of study, (8) received intrathecal baclofen, and (9) balance problems while wearing the restraint.…”

Section: Participants and Recruitmentmentioning

confidence: 99%

“…1 This disuse, in turn, may lead to additional impairments secondary to neural damage associated with CP. Interestingly, we have found that, in the laboratory environment, repetitive practice of a motor task with the involved hand can result in improved performance 2,3 in a relatively short time period. This observation suggests that the involved upper extremity is amenable to treatment and that intensive practice may be beneficial to improve function.…”

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confidence: 90%

Efficacy of Constraint-Induced Movement Therapy on Involved Upper-Extremity Use in Children With Hemiplegic Cerebral Palsy Is Not Age-Dependent

2006

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OBJECTIVES. Constraint-induced (CI) movement therapy has been shown recently to be promising for improving upper-limb function in children with cerebral palsy (CP). Because little is known about patient characteristics predicting treatment efficacy, not all children may benefit from this intervention. Here we examine the relationship between efficacy of a child-friendly form of CI therapy and age on involved upper-extremity function.DESIGN. Twenty children with hemiplegic CP age 4 to 13 years received CI therapy and completed evaluations. Based on established functional and neuromaturational changes in hand skill development, the children were divided into a "younger group" (age 4 -8 years, n ϭ 12) and "older group" (age 9 -13 years, n ϭ 8). Children wore a sling on their noninvolved upper extremity for 6 hours per day for 10 of 12 consecutive days, during which time they were engaged in play and functional activities. Each child was evaluated by trained evaluators who were blinded to the fact that the children received treatment. The evaluations took place once before the intervention and at 1 week, 1 month, and 6 months after the intervention. Efficacy was examined at the movement efficiency (Jebsen-Taylor Test of Hand Function, subtest 8 of the Bruininks-Oseretsky Test of Motor Proficiency), environmental (caregiver frequency and quality of involved upper-limb use), and impairment (strength, tactile sensitivity, and muscle tone) levels.RESULTS. Children in both age groups had significant improvements in involved hand-movement efficiency and environmental functional limitations, which were retained through the 6-month posttest. However, there were no differences in efficacy between younger and older children. Both hand severity and the children's behavior during testing (number of redirections), with the latter serving as a reasonable correlate for attention during the intervention, were related to changes in performance in the younger group but not in the older group. IMPAIRED HAND FUNCTION is a major disability in children with hemiplegic cerebral palsy (CP). As a result, children with hemiplegic CP often fail to use the involved upper extremity and learn to perform most tasks exclusively with their noninvolved upper extremity (ie, developmental disuse). 1 This disuse, in turn, may lead to additional impairments secondary to neural damage associated with CP. Interestingly, we have found that, in the laboratory environment, repetitive practice of a motor task with the involved hand can result in improved performance 2,3 in a relatively short time period. This observation suggests that the involved upper extremity is amenable to treatment and that intensive practice may be beneficial to improve function.A recent therapeutic intervention, constraint-induced (CI) movement therapy, seems promising for children with hemiplegic CP. It provides an opportunity for such practice with the involved hand and arm as a result of restraining the noninvolved upper extremity along with providing structured practice (...

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“…Unfortunately, evidence-based treatments of impaired hand function are largely lacking. 4 Children with hemiplegia may benefit from intensive unimanual practice, 5 intensive contemporary occupational therapy 6 or goal-directed training combined with botulinum toxin. 7 One recent treatment approach providing intensive unimanual practice, constraint-induced movement therapy (CIMT), has shown promise for the improvement of unimanual hand function.…”

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confidence: 99%

Efficacy of a hand–arm bimanual intensive therapy (HABIT) in children with hemiplegic cerebral palsy: a randomized control trial

Gordon

Schneider

Chinnan

et al. 2007

Develop Med Child Neuro

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Children with hemiplegic cerebral palsy (CP) have impairments in bimanual coordination above and beyond their unilateral impairments. Recently we developed hand‐arm bimanual intensive therapy (HABIT), using the principles of motor learning, and neuroplasticity, to address these bimanual impairments. A single‐blinded randomized control study of HABIT was performed to examine its efficacy in children with hemiplegic CP with mild to moderate hand involvement. Twenty children (age range 3y 6mo‐15y 6mo) were randomized to either an intervention (n=10: seven males, three females; mean age 8y 7mo, SD 4y) or a delayed treatment control group (n=10: seven males, three females; mean age 6y 10mo, SD 2y 4mo). Children were engaged in play and functional activities that provided structured bimanual practice 6 hours per day for 10 days. Each child was evaluated immediately before and after the intervention, and again at 1‐month post‐intervention. Children in the intervention group demonstrated improved scores on the Assisting Hand Assessment, increased involved extremity use measured using accelerometry and a caregiver survey, bimanual items of the Bruininks–Oseretsky Test of Motor Proficiency, and the simultaneity of completing a draw‐opening task with two hands (p<0.05 in all cases). The results suggest that for this carefully selected subgroup of children with hemiplegic CP, HABIT appears to be efficacious in improving bimanual hand use.

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Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. I: Anticipatory scaling

Cited by 56 publications

References 31 publications

Fingertip Force Planning During Grasp Is Disrupted by Impaired Sensorimotor Integration in Children With Hemiplegic Cerebral Palsy

Fingertip Force Planning During Grasp Is Disrupted by Impaired Sensorimotor Integration in Children With Hemiplegic Cerebral Palsy

Efficacy of Constraint-Induced Movement Therapy on Involved Upper-Extremity Use in Children With Hemiplegic Cerebral Palsy Is Not Age-Dependent

Efficacy of a hand–arm bimanual intensive therapy (HABIT) in children with hemiplegic cerebral palsy: a randomized control trial

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