Upper Extremity Impairments and Activities in Children with Bilateral Cerebral Palsy

Abstract

Background: There is a lack of evidence about the upper extremity impairments and function in children with diparetic cerebral palsy. Objectives: This study was planned to investigate the upper extremity impairments, dexterity, grip strength and function in the daily living activities in children with diparetic cerebral palsy (CP). Methods: Eighteen children with diparetic CP and 15 typical peers between the ages 5 -12 years were included in the study. Manual Ability Classification System (MACS) was used for the classification of upper extremity fine motor skills; WeeFIM for activities of daily living; Abilhand-Kids for the manual abilities; and Pediatric Evaluation of Disability Inventory (PEDI) for the disability in the daily living activities respectively. Grip strength was evaluated with Jamar Hand Dynamometer, hand functions were assessed with Nine-hole Peg Test and Jebsen-Taylor test. Results: Children with diparetic CP were affected in manual abilities and functions, grip strength, activities of daily living, and levels of disability and the results were statistically significant (P < 0.05). Conclusions: As a conclusion, upper extremity impairments, dexterity, grip strength, and functions in the activities of daily living are affected in children with diparetic CP. Physiotherapy interventions for upper extremities and hand should be included as well as the lower extremities in the treatment of the spastic diparetic children.

Pinch grip strength and fine manual control in children with diplegic cerebral palsy: a cross-sectional study

“…The results of this study supported by Kara et al [7] who evaluated the gross and fine motor skills of 73 children with diplegic CP aged between 6 and 12 years by Bruininks-Oseretsky Test 2-Short Form and reported that the mean and standard deviation with (minimum and maximum vales) of girls and boys for fine motor precision were 1.76 ± 1.04 (0-3) and 1.25 ± 0.96 (0-4), and for fine motor ıntegration were 5.32 ± 1.90 (3-9) and 4.58 ± 1.44 (2-8) respectively. Our results confirming findings reported by study done by Elbasan et al [17] which assessed finger dexterity by Nine-hole Peg Test and assessed fine and gross motor hand function using simulated activities of daily living with Jebsen-Taylor test and observed that children with diplegic CP were inadequate in their fine motor skills compared to the healthy peers and suggested that beside the main cause of corticospinal pathways affection, the over protective attitudes of the family members on these children restrict the use of their hands that affect the development of their fine motor skills. The fine motor integration was significantly impaired in children with diplegia compared with the control group.…”

“…This study showed significant decrease in tip, tripod, and key pinch strength in children with diplegia that is supported by the results of Elbasan et al [17] who evaluated hand grip strength with Jamar Hand Dynamometer for 18 children with spastic diplegia, aged between 5 and 12 years and compared their results with 15 typically developing peers. They found decrease in the hand strength of the dominant and non-dominant hands in children with spastic diplegia compared to healthy children of the same age.…”

“…Several studies have provided comprehensive normative data on the grip strength of healthy children [12,14,15]. Studies on diplegic children focused mainly on hand grip strength and dexterities [16,17] with little attention on pinch strength, and fine motor precision and integration. There is no literature that specifies the relation between the three types of pinch grip strength and fine motor precision and integration.…”

The activity levels and quality of life of physically disabled children who continued or did not continue rehabilitation during the COVID-19 pandemic

“…Sample size was determined using power analysis and the results showed that a minimum of 18 patients was necessary in each group to be able to determine the minimum significant difference clinically with 8% power and 5% error level. Thus, the study included 18 children with physical disabilities who continued rehabilitation, and 18 children with physical disabilities who did not continue rehabilitation during the COVID-19 pandemic [18].…”