Related Experiment Video
Updated: Jul 31, 2026
Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
Hand function in children with hemiplegic cerebral palsy: prospective follow-up and functional outcome in adolescence
Ermellina Fedrizzi1, Emanuela Pagliano, Elena Andreucci
1Developmental Neurology Division, Neurological Institute C Besta, Milano, Italy.
Insights
Hand function in children with hemiplegic cerebral palsy shows limited improvement in grip and stable spontaneous use over time. Early intensive therapy is crucial for severe cases, while less affected children need regular follow-up.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Hemiplegic cerebral palsy (CP) significantly impacts affected hand function in children.
- Assessing hand impairment and disability is crucial for effective intervention planning.
Purpose of the Study:
- To prospectively evaluate the long-term outcomes of affected hand impairment and disability in children with hemiplegic cerebral palsy.
- To determine the efficacy of grip and spontaneous hand use assessments in understanding functional limitations.
Main Methods:
- Prospective study of 31 children with hemiplegic CP, followed from early childhood to adolescence.
- Hand function assessed using video-recorded grip and spontaneous use tasks at baseline and follow-up.
- Longitudinal analysis of hand function changes over time.
Main Results:
- Children exhibited greater impairment in spontaneous hand use compared to gripping tasks.
- Grip function showed non-significant improvement, while spontaneous use remained stable from early childhood to adolescence.
- Children with initially good hand function maintained it, especially with treatment; improvement in lower-scoring children was more pronounced in grip and occurred early.
Conclusions:
- Grip assessment alone is insufficient to evaluate hand disability in hemiplegic CP; spontaneous use in bilateral tasks is critical.
- Intensive early intervention is recommended for children with severe hand impairment.
- Regular follow-up is adequate for children with less severe hand involvement.
Abstract:
The aim of this prospective study was to determine the outcome of affected hand impairment and disability in a group of 31 children (16 males, 15 females) with hemiplegic cerebral palsy who were referred consecutively to our rehabilitation service and followed from a mean age of 2 years and 7 months to a mean age of 12 years and 9 months. The hand function assessment protocol consisted of video-recorded procedures: one to assess grip and the other to assess the extent of spontaneous use of the affected hand. Assessments at outset and at latest follow-up showed that the series as a whole had greater hand impairment in spontaneous manipulation than in gripping tasks. Comparison of hand function before age 4 years with the latest assessment over age 11 years revealed a non-significant improvement in grip, whereas spontaneous hand use remained stable. All but one of the children who had good grip and hand use scores at first assessment maintained them over time unless they were not treated for hand dysfunction. Among the children with low scores at outset, the improvement over time was more marked in grip than spontaneous hand use and occurred mainly in the early years. These results suggest that to evaluate the real disability of the affected hand in children with hemiplegia, grip assessment is insufficient and that an instrument assessing spontaneous hand use in bilateral manipulation is required. Furthermore, intensive treatment focused on hand function should be planned in the early years for children with more severe hand impairment, whereas regular follow-up is sufficient for less affected children.
