Upper Limb Motor Planning in Individuals with Cerebral Palsy Aged between 3 and 21 Years Old: A Systematic Review

Abstract

Individuals with cerebral palsy have difficulties performing activities of daily living. Beyond motor execution impairments, they exhibit motor planning deficits contributing to their difficulties. The objective of this review is to synthesize the behavioral evidence of motor planning deficits during an upper limb motor task in children, adolescents and young adults with cerebral palsy aged between 3 and 21 years. Methods: The inclusion criteria were: (1) including individuals with cerebral palsy from 3 to 21 years old; (2) assessing upper limb motor planning. Six databases were screened. The quality assessment of the studies was performed. Results: Forty-six studies and 686 participants were included. Five articles have been identified as very high quality, 12 as high, 20 as moderate, six as low, three as very low. Force planning studies reported a deficit for the more affected hand but adequate performances for the less affected hand. Object-manipulation studies reported hand posture planning deficits irrespectively of the hand assessed. Conclusions: Motor planning deficits has been shown in the more affected hand for force scaling, while the results for other variables showed overall deficits. Hence, variables affected by motor planning deficits in both hands should be considered in children with cerebral palsy to optimize intervention.

Anticipatory Motor Planning and Control of Grasp in Children with Unilateral Spastic Cerebral Palsy

“…Thus, additional torque was applied after lift-off to further minimize roll. The anticipatory control of forces and torque is in line with prior studies that demonstrated children with USCP generally have intact anticipatory control of kinetics in the less-affected hand [7,16,17,27].…”

“…The biomechanical disadvantage of not using the passive lever arm in order to account for subsequent actions is in line with past studies that demonstrated impairments relating to kinematic scaling and end-state comfort in the less-affected hand [1,2,7,16,17]. This is comparable to previous studies where a multi-step action was performed such as placing a cylinder on a shelf [6], where children with USCP are able to grasp the object, but do not account for what will be done with the object (i.e., place a cylinder on a shelf, or in this study to keep the object level).…”

“…They do not take end-state comfort [ 4 ] into account when planning a multi-step action such as turning a doorknob [ 5 ] or placing a cylinder on a shelf [ 6 ]. Such impairments have been shown to occur even when using the less-affected hand [ 1 , 2 ], suggesting higher-level planning deficits [ 7 ].…”

Spatiotemporal coordination in children with unilateral cerebral palsy: insights from a bimanual goal-directed task

“…Indeed, it is well-described that children with uCP can have motor planning de cits. 19 Hence, investigating motor planning in relation to this task, as well as which is the preferred condition is needed to further understand how children with uCP plan and coordinate both hands.…”

Children With Bilateral Cerebral Palsy Exhibit Bimanual Asymmetric Motor Deficits and EEG Evidence of Dominant Sensorimotor Hemisphere Overreliance During Reaching

“…In a recent review on upper limb motor planning in CP, only 3.5% of individuals in included studies had bilateral CP. 9 Similarly, in another review on the evaluation and characterization of manual function, 23% of participants had bilateral CP. 10 However, the disproportionate focus on upper limb function in unilateral CP does not signify that manual function is not impaired in bilateral CP.…”