Related Experiment Video
Updated: May 25, 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
Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy
Katrijn Klingels1, Inge Demeyere, Ellen Jaspers
1Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Heverlee, Belgium. katrijn.klingels@faber.kuleuven.be
Insights
Upper limb impairments in children with unilateral cerebral palsy (CP) vary by Manual Ability Classification System (MACS) level and lesion timing. Distal muscle strength significantly impacts unimanual and bimanual activity in congenital CP.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Occupational Therapy
Background:
- Understanding upper limb impairments in unilateral cerebral palsy (CP) is crucial for effective treatment.
- Activity limitations are closely linked to these impairments, impacting daily function.
Purpose of the Study:
- Investigate upper limb impairments and activity limitations in children with unilateral CP.
- Compare findings based on Manual Ability Classification System (MACS) level, lesion timing (congenital/acquired), and age.
- Determine the influence of specific impairments on measured activity levels.
Main Methods:
- Eighty-one children (5-15 years) with unilateral CP participated.
- Assessed passive range of motion (PROM), muscle tone, strength, and sensibility.
- Evaluated activity limitations using the Melbourne Assessment, Assisting Hand Assessment (AHA), and Abilhand-Kids.
Main Results:
- Elbow extension, supination, distal muscle tone/strength, and sensory discrimination were most affected.
- Lower MACS levels and acquired lesions correlated with greater impairments and activity limitations.
- For congenital CP, wrist strength, stereognosis, and proprioception predicted unimanual capacity (76% variance). Wrist and grip strength predicted bimanual performance (76% variance). Wrist strength and stereognosis predicted general hand skills (46% variance).
Conclusions:
- MACS level and lesion timing are key for differentiating impairment and activity profiles in unilateral CP.
- Distal muscle strength is a primary determinant of unimanual capacity and bimanual performance in congenital unilateral CP.
- Impairment-based interventions targeting distal strength are recommended for children with congenital unilateral CP.
Background:
Insights in upper limb impairments and their relationship with activity measures in children with unilateral cerebral palsy (CP) are important to optimize treatment interventions.
Aims:
(1) To investigate upper limb impairments and activity limitations in children with unilateral CP; (2) to compare these according to the Manual Ability Classification System (MACS), timing of lesion (congenital/acquired) and age; (3) to determine the impact of impairments on activity measures.
Methods:
Eighty-one children with unilateral CP aged 5-15 years (mean 9 years 11 months; congenital N=69, acquired N=12) were recruited. Body function measurements included passive range of motion (PROM), muscle tone, strength and sensibility. At activity level, the Melbourne Assessment, Assisting Hand Assessment (AHA) and Abilhand-Kids were assessed.
Results:
Most PROM limitations were found for elbow extension and supination. Increased tone and weakness were most prominent in distal muscles. Stereognosis and two-point discrimination were mostly affected. Children with a lower MACS level or acquired lesion had significantly more impairments and activity limitations. In children with congenital lesions, best predictors for unimanual capacity (Melbourne Assessment) were wrist strength, stereognosis and proprioception, and for bimanual performance (AHA) wrist strength and grip strength, explaining 76% of the variance. For the Abilhand-Kids, wrist strength and stereognosis predicted 46% of the variance.
Conclusions:
Classification according to MACS and timing of lesion is important to differentiate within the wide range of impairments and activity limitations. In children with congenital lesions, unimanual capacity and bimanual performance are highly determined by distal strength, supporting the additional use of impairment-based interventions.
More Related Videos
05:28Application of a Dual Upper Limb Task-Oriented Robotic System for the Functional Recovery of the Upper Limb in Stroke Patients
Published on: October 11, 2024
07:35Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System
Published on: December 29, 2023