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Functional assessment aided by motion laboratory studies.

Ann E Van Heest1

  • 1Department of Orthopedic Surgery, University of Minnesota, 2450 Riverside Avenue South R200, Minneapolis, MN 55454, USA. vanhe003@tc.umn.edu

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This study details assessing upper limb function in children with cerebral palsy (CP). Comprehensive evaluation guides surgical interventions like tendon transfers for improved limb use and function.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Rehabilitation
  • Cerebral Palsy Management

Background:

  • Cerebral palsy (CP) presents complex upper limb functional deficiencies due to spasticity, flaccidity, and sensory deficits.
  • Effective management requires integrating assessments of motor control, contractures, and sensory input.
  • Surgical interventions, including tendon transfers and muscle lengthening, offer significant functional improvements for select CP patients.

Purpose of the Study:

  • To outline a comprehensive assessment framework for upper limb dysfunction in children with cerebral palsy.
  • To guide the selection of appropriate surgical interventions based on individual patient evaluations.
  • To identify ideal candidates for tendon transfer surgery and predict potential functional gains.

Main Methods:

  • Integration of functional use patterns, static contractures, dynamic deformities, and sensory deficiencies.
  • Assessment of mentation, motivation, and general medical condition.
  • Utilizing observation, examination, functional testing, and motion laboratory analysis for motor deficiency assessment.

Main Results:

  • Tendon transfers effectively augment specific movements in cases of flaccid control.
  • Muscle lengthening addresses excessive spasticity and contractures.
  • Children with passive limb use (Functional Use Classification levels 1-3) show average improvement of 2.7 levels towards active use (levels 4-6).

Conclusions:

  • A thorough, multi-faceted assessment is crucial for developing an individualized treatment plan for upper limb reconstruction in CP.
  • Surgical interventions, particularly tendon transfers, can significantly enhance upper limb function in appropriately selected pediatric patients.
  • Early and accurate assessment is the foundational step towards successful surgical management and improved quality of life for children with CP.