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.

Effect of parent‐delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial

“…13 All three have excellent psychometric properties. Furthermore, scores on these assessments do not spontaneously improve over 1 year in children with UCP.…”

“…Secondary outcome measures were the MA2 17 measuring unimanual capacity, and the ABIL-HAND-Kids questionnaire 13 measuring hand function in activities of daily living. These were completed at baseline, 3 months to assess the effect of the intervention, and 6 months to assess maintenance of effects.…”

“…Baseline assessments, specifically AHA, 12 Melbourne Assessment-2 (MA2), 17 and ABILHAND-Kids, 13 were used to establish areas of difficulty in manual activities for each child, such as reaching, grasp, and manipulating small items. These, along with the child's interests and abilities, informed the choice of intervention activities.…”

“…Interestingly, no betweengroup differences were observed in the MUUL. 13 Intervention delivery in these studies is therapistintensive and, arguably, does not make the best use of therapist time and skills. Recently, parent-delivered occupational therapy home programmes for children with CP were shown to improve performance and parental satisfaction with upper limb function, 14 and CIMT 15 and HABIT 16 have also been explored in home-based settings with encouraging findings.…”

Translation, cross-cultural adaptation and validation of the ABILHAND-Kids for the Brazilian Portuguese

“…Non-progressive chronic encephalopathy, also known as cerebral palsy (CP), is one of the most common cause of children's disability and the prevalence rate is 2 to 5 cases per 1,000 born alive 1,2 . CP comprises a group of permanent movement and posture disorders, resulted from non-progressive disturbances that occurred in the developing fetal or infant brain 3 .…”