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Updated: Sep 23, 2026
An Objective and Child-friendly Assessment of Arm Function by Using a 3-D Sensor
Published on: February 12, 2018
Development of hand function among children with cerebral palsy: growth curve analysis for ages 16 to 70 months
Steven E Hanna1, Mary C Law, Peter L Rosenbaum
1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. hannas@mcmaster.ca
Insights
This study tracked young children with cerebral palsy (CP) and upper-extremity involvement. Hand function develops differently than overall upper-extremity skills, with declines more common in older children.
Area of Science:
- Pediatric Rehabilitation
- Neurodevelopmental Disorders
- Motor Function Assessment
Background:
- Cerebral palsy (CP) significantly impacts motor development in children.
- Understanding the trajectory of hand and upper-extremity function is crucial for early intervention.
- Upper-extremity involvement is a common characteristic of CP, affecting daily activities.
Purpose of the Study:
- To document the longitudinal development of hand and upper-extremity function in young children with CP.
- To identify factors influencing developmental trajectories, including CP distribution and impairment severity.
- To analyze interindividual variations in functional development over time.
Main Methods:
- Longitudinal study design with assessments over 10 months.
- Inclusion of 51 children (29 males, 22 females) aged 16-60 months at baseline.
- Application of linear mixed effects modeling to analyze developmental curves and individual differences.
Main Results:
- Hand function and upper-extremity skills show distinct developmental patterns in children with CP.
- Declines in upper-extremity skills were more prevalent and pronounced in older children within the cohort.
- CP distribution and impairment severity significantly predicted developmental outcomes, with considerable individual variation observed.
Conclusions:
- The development of hand function diverges from general upper-extremity skills in pediatric CP.
- Clinical interventions should consider the specific patterns of upper-extremity skill development and individual variability.
- Severity and body-site distribution of CP are key factors influencing functional outcomes in young children.
Abstract:
This study documents the development of hand and upper-extremity function in young children who have cerebral palsy (CP) with upper-extremity involvement using longitudinal data. Assessments of hand function and the quality of upper-extremity movement were conducted on 29 males and 22 females (mean age 36.2 months, SD 10.6; age range 16 to 60 months at baseline) and on four other occasions over 10 months. Linear mixed effects modeling was used to estimate average developmental curves and the degree of individual differences in the patterns of development which were conditional on the body-site distribution of CP and severity of impairments. Results indicate that hand function in this clinical population develops differently from overall upper-extremity skills with declines in function in upper-extremity skills being more common and pronounced among older children. However, there is substantial interindividual variation. Distribution of CP and severity of impairments were significant predictors of development. Results are discussed in terms of their clinical implications.
