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Published on: January 11, 2016
Impact of tactile dysfunction on upper-limb motor performance in children with unilateral cerebral palsy
Megan L Auld1, Roslyn N Boyd, G Lorimer Moseley
1Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. mauld@uq.edu.au
Insights
Tactile spatial deficits significantly impact upper-limb function in children with unilateral cerebral palsy (CP). Addressing these sensory issues is crucial for improving motor skills in affected children.
Area of Science:
- Pediatric Neurology
- Neurorehabilitation
- Developmental Pediatrics
Background:
- Unilateral cerebral palsy (CP) often presents with complex motor and sensory challenges.
- Upper-limb dysfunction is a primary concern affecting daily activities in children with unilateral CP.
- The relationship between tactile processing and motor control in this population requires further elucidation.
Purpose of the Study:
- To investigate the association between tactile sensory function and upper-limb motor capabilities in children diagnosed with unilateral CP.
- To identify specific tactile deficits that correlate with unimanual and bimanual upper-limb performance.
Main Methods:
- A cross-sectional study involving 52 children (aged 8-18 years) with unilateral CP.
- Tactile function was assessed using tests for registration, spatial perception (e.g., single point localization, double simultaneous), and texture perception.
- Upper-limb motor function was evaluated using standardized unimanual (Melbourne Unilateral Upper Limb Assessment, Jebsen-Taylor Test of Hand Function) and bimanual (Assisting Hand Assessment) assessments.
Main Results:
- Moderate correlations were found between tactile registration, spatial perception, and upper-limb function (MUUL, JTTHF, AHA; P<.001).
- Texture perception did not show a significant relationship with upper-limb motor function.
- Tactile spatial perception tests, such as single point localization and double simultaneous, explained a substantial portion of the variance in unimanual (26-29%) and bimanual (33%) upper-limb function, respectively.
Conclusions:
- Spatial tactile deficits are significantly associated with, and contribute to, upper-limb motor impairments in children with unilateral CP.
- Approximately 30% of the variance in upper-limb function can be attributed to spatial tactile deficits.
- Routine tactile assessments and targeted interventions for tactile spatial deficits are recommended for children with unilateral CP.
Objective:
To determine the relationship between tactile function and upper-limb function in children with unilateral cerebral palsy (CP).
Design:
Cross-sectional study.
Setting:
Assessments were performed in community or hospital venues or in participants' homes.
Participants:
Recruitment information was sent to 253 possible participants with unilateral CP (aged 8-18 y), and N=52 participated (median age [interquartile range], 12 y [9-14 y]; Gross Motor Functional Classification System level I=34; II=18; Manual Abilities Classification Scale level I=36; II=16).
Interventions:
Not applicable.
Main Outcome Measures:
Tactile assessment included 1 test of registration, 5 tests for spatial perception, and 1 test for texture perception. Upper-limb motor function was assessed using 2 unimanual tests, the Melbourne Unilateral Upper Limb Assessment (MUUL) and Jebsen-Taylor Test of Hand Function (JTTHF), and 1 bimanual test, the Assisting Hand Assessment (AHA).
Results:
Tactile registration and all tests of spatial perception were moderately related to the MUUL, JTTHF, and AHA (P<.001). Texture perception was not related to upper-limb motor function. Regression analysis showed that single point localization, a unilateral tactile spatial perception test, contributed most strongly to unimanual capacity (29% explained variance in MUUL and 26% explained variance in JTTHF), whereas double simultaneous, a bilateral tactile spatial perception test, contributed most strongly to bimanual performance (33% for the AHA).
Conclusions:
Spatial tactile deficits account for approximately 30% of the variance in upper-limb motor function in children with unilateral CP. This emphasizes the need for routine tactile assessment and targeted treatment of tactile spatial deficits in this population.
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