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Recovery of the precision grip in children after traumatic brain injury
Mukaddes Gölge1, Marina Müller, Mona Dreesmann
1Institute of Physiology, Christian-Albrechts-University, Kiel, Germany. m.goelge@physiologie.uni-kiel.de
Insights
Quantitative analysis of precision grip tasks can objectively measure grasping impairments and recovery in children following traumatic brain injury (TBI). Key grip-force and timing parameters show sensitivity in tracking recovery during rehabilitation.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Biomechanics
Background:
- Traumatic brain injury (TBI) in children can lead to significant motor impairments, including difficulties with grasping.
- Objective assessment of grasping function is crucial for monitoring recovery and guiding rehabilitation strategies.
Purpose of the Study:
- To identify quantitative parameters of fingertip forces during a precision grip-lift task that are sensitive to changes in grasping ability in children with TBI.
- To analyze the recovery of grasping function over a 5-month rehabilitation period.
Main Methods:
- A follow-up, case-control study involving 13 children (5-14 years) with moderate to severe TBI and 13 age- and gender-matched healthy controls.
- Quantitative analysis of isometric fingertip forces, including grip force, load force, grip-load force coordination, and timing parameters during a precision grip-lift task.
- Examinations were conducted at three time points (t0, t1, t2) during 5 months of inpatient rehabilitation, with clinical progress assessed using the Barthel Index.
Main Results:
- Significant improvements were observed in peak grip force, maximum negative load force, static grip force and its variability, and the grip-force/load-force ratio over the 5-month period.
- Timing parameters, specifically the preparation phase and preload duration, also showed significant changes, indicating altered motor control.
- Load duration did not show significant changes, suggesting specific aspects of motor control are more affected or recover differently.
Conclusions:
- Quantitative analysis of precision grip tasks provides objective measures of grasping impairments and recovery in children post-TBI.
- Specific grip-force and timing parameters are sensitive indicators of the restitution processes occurring during rehabilitation.
- These quantitative measures can aid in the detailed assessment and monitoring of motor recovery in pediatric TBI patients.
Objective:
To identify quantitative parameters that are sensitive enough to detect impairments and improvements of grasping in children after traumatic brain injury (TBI) by analyzing the isometric fingertip forces of a precision grip-lift task.
Design:
Follow-up and case-control study.
Setting:
Tertiary pediatric trauma rehabilitation center in Germany.
Participants:
Thirteen children (age range, 5-14 y) with moderate or severe TBI. Trauma severity was assessed with the Glasgow Coma Scale (score range, 3-9) and the Injury Severity Score (range, 16-66 points). Control data were obtained from 13 age- and gender-matched healthy children.
Interventions:
Not applicable.
Main Outcome Measures:
Children were examined 3 times (t0, t1, t2). The first date of examination (t0) was defined by the Barthel Index (part B, >20 points). Reexaminations followed after 1 (t1) and 5 (t2) months of inpatient rehabilitation. Quantitative measures included 3 grip-force parameters, 2 load force parameters, 1 parameter of the coordination between grip force and load force, and 3 timing parameters in a precision grip-lift task. Clinical improvements and recovery of activities of daily living were described with the Barthel Index (qualitative measure).
Results:
Peak grip force, maximum negative load force, grip force in the static phase and its standard deviation, and grip-force/load-force ratio at maximum grip force showed significant improvements during the observation period (5 mo). Also, the preparation phase and preload duration, but not the load duration, changed significantly.
Conclusions:
Impairments and the recovery of grasping in children after TBI can be objectified with quantitative analyses of the precision grip. Several grip-force and timing parameters were sensitive for the description of restitution processes.
