Hand impairments and their relationship with manual ability in children with cerebral palsy

Abstract

Objective: To study hand impairments and their relationship with manual ability in children with cerebral palsy. Design: Cross-sectional survey. Patients: A total of 101 children with cerebral palsy (mean age 10 years, age range 6-15 years) were assessed. Methods: Three motor and 3 sensory impairments were measured on both hands. Motor impairments included grip strength (Jamar dynamometer), gross manual dexterity (Box and Block Test) and fine finger dexterity (Purdue Pegboard Test). Sensory impairments included tactile pressure detection (Semmes-Weinstein aesthesiometer), stereognosis (Manual Form Perception Test) and proprioception (passive mobilization of the metacarpophalangeal joints). Manual ability was measured with the ABILHAND-Kids questionnaire. The relationship between hand impairments and manual ability was studied through correlation coefficients and a multiple linear forward stepwise regression analysis. Results: Motor impairments were markedly more prevalent than sensory ones. Gross manual dexterity on the dominant hand and grip strength on the non-dominant hand were the best independent predictors of the children's manual ability, predicting 58% of its variance. Conclusion: Hand impairments and manual ability are not related in a predictable straightforward relationship. It is important that, besides hand impairments, manual ability is also measured and treated, as it is not simply the integration of hand functions in daily activities.

Affected and Contralateral Hand Strength and Dexterity Measures in Children With Hemiplegic Cerebral Palsy

“…Slower speed of movements 15 has been shown with both hands during keyboarding that requires finger aiming and repetition. 13 When the hemiplegic hand is being challenged, mirror movements can occur at the same time in the dominant hand. 14 Subtle deficits in fingertip forces have been observed in the sequencing of the grip-lift movement 5 and fine-finger dexterity.…”

“…Is the contralateral hand a "good," 9 "unimpaired" 2,4 hand" or does it have "subtle deficits" 3e6, 9,10 ? Some authors have reported delays in the development of anticipatory control of grasp formation, 11 speed in movements, 12 fine finger dexterity, 13 and mild sensory impairments in the contralateral hand. 2,8 Children with hemiplegic cerebral palsy may present with substantial deficits in hand function, because bimanual activities involve the ability to use the affected and contralateral hands together for grasp and stabilization.…”

Think twice before re-manipulating distal metaphyseal forearm fractures in children

“…To assess the subjective outcome, patient satisfaction regarding wrist function, cosmetic appearance and pain was documented using Visual Analogue Scales (VAS). The ABILHANDS-kids questionnaire was used to assess hand function in daily activities [26,27]. Overall outcome was graded according to the criteria of Price et al [8,28].…”

Hand Functioning in Children with Cerebral Palsy

“…Cerebral palsy (CP) is the most prevalent form of physical disability in children (1), occurring in 1 out of 303 live births (). Almost 50% of children with CP present an arm–hand dysfunction (2, 3). Children with unilateral spastic CP seldom use their paretic hand spontaneously in daily activities (2, 4).…”