Impaired force coordination during object release in children with hemiplegic cerebral palsy

Abstract

Recent studies on hand motor control in children with cerebral palsy (CP) have focused on the coordination of fingertip forces during the grasping and lifting of objects. However, little is known about the ability to replace and release an object from grasp, a function that is just as important for fine dexterity. The present study examines the coordination of fingertip forces during the replacement and release of an object (either 200 g or 400 g) from grasp in 14 children (aged between 7 and 13 years) with hemiplegic CP and in 14 age‐matched typically developing children. The results indicate that children with hemiplegic CP abruptly replaced the object but had a prolonged and uncoordinated release of the grasp. Unlike what was seen in the control children, the grip and load forces decreased sequentially in the children with CP. However, all the children could appropriately scale the rate of force decrease based on somatosensory weight‐related information from the ongoing lift. The results provide further information about the impaired hand skills in children with hemiplegic CP.

Grip strength parameters and functional activities in young adults with unilateral cerebral palsy compared with healthy subjects

“…Studies comparing grip force between patients with CP and control subjects have reported conflicting results. One study reported decreased maximal grip force in patients with CP (11), while others reported no differences in static grip force between patients with CP and controls (12,13).…”

“…For example, muscle coordination and muscle endurance may not be reflected in a maximal voluntary contraction, while they may be similarly important in the performance of skilled manual tasks in daily activities. It is known that patients with CP have deficits in motor control, mainly due to involuntary co-activation of the antagonistic muscles (13). Several studies (12,13) reported an impaired force coordination of fingertip forces, resulting in a prolonged and uncoordinated release of a grasped object.…”

Avaliação de habilidades motoras de uma criança com paralisia cerebral incluída em contexto escolar regular

“…Na atividade de escrita, apresentou dificuldade para estabilizar o caderno com a mão acometida enquanto escrevia com a mão não acometida. A realização de atividades motoras bimanuais é complexa e difícil para crianças com hemiparesia, principalmente quando tais atividades envolvem movimentos com componentes assimétricos, como recortar um papel com a tesoura e a escrita manual (ELIASSON; GORDON, 2000;HUNG;CHARLES;GORDON, 2004).…”

Prognóstico motor e perspectivas atuais na paralisia cerebral

“…Crianças hemiplégicas evoluem com piora da função manual 29 e sua principal dificuldade será realizar tarefas que requerem manipulação bilateral 30,31 . As maiores modificações na função da preensão palmar ocorrem durante os primeiros anos de vida 29 .…”