The contributing role of real‐life hand skill performance in self‐care function of children with and without disabilities

Chien, Chun-Ru; Brown, Ted; McDonald, Rachael; Yu, Mong-Lin

doi:10.1111/j.1365-2214.2012.01429.x

Cited by 8 publications

(8 citation statements)

References 37 publications

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“…The results indicated that upper limb function in children with CP (assessed using MA2 and ULPRS) was primarily correlated with the PEDI-CAT daily activity domain rather than other domains. Real-life hand skill performance was reported to be a contributing factor of self-care function in children with and without disabilities [26]. Previous research reported a strong correlation between upper-extremity function (assessed using the original Melbourne Assessment) and the PEDI self-care domain [17], which is consistent with our results correlating the PEDI-CAT daily activity domain (equivalent to the original PEDI functional skills of self-care domain) with upper-extremity function.…”

Section: Discussionsupporting

confidence: 92%

Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study

Park

Choi

et al. 2021

BMC Pediatr

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Background There are differences in roles between the more-affected and less-affected upper limb of children with cerebral palsy (CP). However, there is a lack of studies of the relationship between the more-affected limb function and activities of daily living (ADL) in children with CP. Thus, the aim of this prospective cross-sectional study was to investigate the relationship between more-affected upper limb function and ADL in children with CP. Methods Children with spastic CP (unilateral CP n = 28, bilateral CP n = 31; 34 males, 25 females; mean age ± SD, 6.8 ± 3.1y [range, 3-14y]) participated in this study. Function of the more-affected upper limb was measured using the Melbourne Assessment of Unilateral Upper limb Function, version 2 (MA2) and the Upper Limb Physician’s Rating Scale (ULPRS). Performance of daily living activities was measured using the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). Results The range, accuracy and fluency dimension of MA2 and ULPRS total scores were moderately correlated with the daily activity domain (r = 0.47, 0.47, 0.56 for MA2 and r = 0.50 for ULPRS, respectively; P < 0.001) rather than the mobility, social/cognitive, and responsibility domains of the PEDI-CAT. ULPRS scores for elbow extension, supination in extension, supination in flexion, and two-handed function were moderately correlated with the PEDI-CAT daily activity domain (r = 0.44, 0.43, 0.41, and 0.49, respectively; P < 0.01). Finger opening and thumb-in-palm deformity of the ULPRS did not correlate with any PEDI-CAT domain. Conclusions The MA2 range, accuracy, and fluency domains (rather than dexterity) had the strongest correlations with the PEDI-CAT daily activity domain. Elbow extension, forearm supination, and two-handed function (rather than wrist and finger movements) of the ULPRS had the strongest correlations with the PEDI-CAT daily activity domain.

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Section: Discussionsupporting

confidence: 92%

Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study

Park

Choi

et al. 2021

BMC Pediatr

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“…[2][3][4][5][6][7] Self-care performance involves a complex interaction between children's personal characteristics (development, physical abilities, health, cognition, motivation) [8][9][10] and their experiential contexts (family, culture, physical environment). 8,9,11 Self-care has been identified by parents of children with CP as a priority for intervention. 12,13 Longitudinal studies extending from childhood to adulthood have also been identified as a research priority both by adults with CP and by parents of children with CP.…”

mentioning

confidence: 99%

“…For children with cerebral palsy (CP), progression in self‐care is related to their level of impairment alongside an increase in age 2–7 . Self‐care performance involves a complex interaction between children's personal characteristics (development, physical abilities, health, cognition, motivation) 8–10 and their experiential contexts (family, culture, physical environment) 8,9,11 …”

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confidence: 99%

Self‐care performance in children with cerebral palsy: a longitudinal study

Burgess

Boyd

Chatfield

et al. 2020

Develop Med Child Neuro

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Aim To investigate self‐care developmental trajectories in children with cerebral palsy (CP) across all functional ability levels, according to Manual Ability Classification System (MACS) levels. Method This was a prospective longitudinal population‐based study of 71 children aged from 2 years 6 months to 12 years, with CP (47 [66%] males, 24 [34%] females). Pediatric Evaluation of Disability Inventory (PEDI) measures were taken at 2 years 6 months, 3, 4, and 5 years, and the PEDI ‐ Computer Adaptive Test (PEDI‐CAT) between 8 and 12 years. At 8 to 12 years, children were classified in MACS levels I (21; 30%), II (22; 31%), III (16; 23%), IV (6; 8%), and V (6; 8%). Longitudinal analysis of the PEDI Functional Skills Scale self‐care and PEDI‐CAT daily activities domains used the published linking equation, and multilevel mixed‐effects regression modelling with interaction between age and MACS. Results Between 5 and 12 years of age, children classified in MACS levels I to III continued to show progress in self‐care development (PEDI‐CAT scaled scores estimated change per year: I, 0.72; II, 0.49; III, 0.48). Children classified in MACS level IV showed an upward non‐significant trend between 5 and 8 to 12 years (estimated change 0.42; 95% confidence interval [CI] −0.04 to 0.88). Children in MACS level V showed a decline in self‐care (estimated change: −0.65; 95% CI −1.16 to −0.14). Interpretation Self‐care development attained by 8 to 12 years of age was related to the severity of manual ability impairment. Application of the linking equation from PEDI to PEDI‐CAT is somewhat uncertain at the extreme lower end of the scale. Our study supports recommendations for items to be added to the PEDI‐CAT to address floor effect. What this paper adds Manual Ability Classification System (MACS) levels are most appropriate to use in models predicting self‐care performance. Children classified in MACS levels I to III showed steady rates of improvement in self‐care. Children in MACS level IV showed an upward trend of improvement in self‐care. Children in MACS level V showed a decline in self‐care. Manual ability and self‐care are closely linked in children with cerebral palsy across childhood.

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“…The International Classification of Functioning, Disability, and Health: Children & Youth version acknowledges that a person’s level of functioning is a dynamic interaction between health, personal, and environmental factors 3 . A substantial number of studies have examined factors related to prediction of self‐care development in children with CP 4–12 . A comprehensive study of the determinants of self‐care in preschool children ( n =429) with CP found that child, family, and service factors explained 65% of the variance in self‐care for children classified in Gross Motor Function Classification System (GMFCS) levels I and II, and 75% for GMFCS levels III to V ( n =429, age range 18–60mo) 4 .…”

mentioning

confidence: 99%

Hand function and self‐care in children with cerebral palsy

Burgess

Boyd

Chatfield

et al. 2020

Develop Med Child Neuro

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To examine the relationship between self-care and bimanual performance in children aged 8 to 12 years with cerebral palsy (CP). METHOD This was a cross-sectional study of 74 children with CP (unilateral n=30, bilateral n=44; 48 males, 26 females; median age 9y 8mo [25th, 75th centiles 9y 1mo, 10y 8mo], Manual Abilities Classification System level I=30, II=28, III=16). Self-care was measured using the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), and bimanual performance using the Assisting Hand Assessment (AHA) and Both Hands Assessment (BoHA). Measures of cognition, behavioural regulation, inattention, and gross motor function were included. Analyses used a directed acyclic graph to select variables for linear regression modelling. RESULTS Higher AHA and BoHA scores were associated with higher PEDI-CAT scores. An increase of 1 AHA unit was associated with an increase of 0.12 PEDI-CAT scores, and a 1 BoHA unit increase was associated with an increase of 0.17 PEDI-CAT scores. The BoHA accounted for 57% of variance in PEDI-CAT scores for children with bilateral CP, while BoHA and cognition accounted for 68% of variance. The AHA accounted for 40% of variance in PEDI-CAT scores for unilateral CP with no effect of cognition on self-care. INTERPRETATION Self-care was strongly and positively associated with bimanual performance. Associations between self-care and bimanual performance differed for those with unilateral and bilateral CP.

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The contributing role of real‐life hand skill performance in self‐care function of children with and without disabilities

Abstract: The findings provide evidence that children's real-life hand skill performance is a contributing factor of their self-care function. The assessment of children's hand skill performance in real-life contexts is therefore needed.

Cited by 8 publications

References 37 publications

Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study

Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study

Self‐care performance in children with cerebral palsy: a longitudinal study

Hand function and self‐care in children with cerebral palsy

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