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Published on: January 11, 2016
Hand impairments and their relationship with manual ability in children with cerebral palsy
Carlyne Arnould1, Massimo Penta, Jean-Louis Thonnard
1Laboratory of Rehabilitation and Physical Medicine, Universite catholique de Louvain, Bruxelles, Belgium.
Insights
This study found that gross manual dexterity and grip strength significantly predict manual ability in children with cerebral palsy. Measuring manual ability alongside hand impairments is crucial for effective treatment.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) often leads to hand impairments affecting daily activities.
- Understanding the link between specific hand impairments and overall manual ability is key for targeted interventions.
Purpose of the Study:
- To investigate the relationship between various hand impairments (motor and sensory) and manual ability in children with CP.
- To identify which specific hand impairments are the strongest predictors of manual ability.
Main Methods:
- A cross-sectional survey involving 101 children with CP (aged 6-15 years).
- Assessed grip strength, gross manual dexterity, fine finger dexterity, tactile pressure, stereognosis, and proprioception.
- Manual ability was measured using the ABILHAND-Kids questionnaire.
Main Results:
- Motor impairments were more common than sensory impairments.
- Gross manual dexterity (dominant hand) and grip strength (non-dominant hand) were significant predictors, explaining 58% of the variance in manual ability.
- The relationship between specific impairments and manual ability was not straightforward.
Conclusions:
- Manual ability in children with CP is not solely determined by the sum of individual hand impairments.
- Both hand impairments and overall manual ability should be assessed and addressed in treatment plans.
- Manual ability requires specific consideration beyond just functional hand impairments.
Objective:
To study hand impairments and their relationship with manual ability in children with cerebral palsy.
Design:
Cross-sectional survey.
Patients:
A total of 101 children with cerebral palsy (mean age 10 years, age range 6-15 years) were assessed.
Methods:
Three motor and 3 sensory impairments were measured on both hands. Motor impairments included grip strength (Jamar dynamometer), gross manual dexterity(Box and Block Test) and fine finger dexterity (Purdue Peg-board Test). Sensory impairments included tactile pressure detection (Semmes-Weinstein aesthesiometer), stereognosis(Manual Form Perception Test) and proprioception (passive mobilization of the metacarpophalangeal joints). Manual ability was measured with the ABILHAND-Kids questionnaire. The relationship between hand impairments and manual ability was studied through correlation coefficients and a multiple linear forward stepwise regression analysis.
Results:
Motor impairments were markedly more prevalent than sensory ones. Gross manual dexterity on the dominant hand and grip strength on the non-dominant hand were the best independent predictors of the children's manual ability,predicting 58% of its variance.
Conclusion:
Hand impairments and manual ability are not related in a predictable straightforward relationship. It is important that, besides hand impairments, manual ability is also measured and treated, as it is not simply the integration of hand functions in daily activities.
