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Published on: January 11, 2016
Precision grip control, sensory impairments and their interactions in children with hemiplegic cerebral palsy: a
Yannick Bleyenheuft1, Andrew M Gordon
1Institute of Neuroscience, Université catholique de Louvain, Belgium. yannick.bleyenheuft@uclouvain.be
Insights
Children with hemiplegic cerebral palsy (HCP) experience significant prehension deficits, often linked to underestimated sensory impairments. Targeted neurorehabilitation addressing these sensory issues can improve motor control and functional independence.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Developmental Pediatrics
Background:
- Children with hemiplegic cerebral palsy (HCP) often have long-term functional deficits, particularly in prehension, impacting independence.
- Loss of prehension in HCP may stem from underlying sensory deficits, necessitating a deeper understanding for effective neurorehabilitation.
Purpose of the Study:
- To review precision grip and sensory impairments in HCP.
- To explore the relationship between sensory impairments and prehension deficits.
- To determine if sensory deficits influence prehensile force control in HCP.
Main Methods:
- Systematic literature review of studies from 1990-2012.
- Searched PubMed and Scopus databases using keywords related to fingertip force, grip force, precision grip, sensory deficit, tactile discrimination, and cerebral palsy.
- Included 38 studies out of 190 identified.
Main Results:
- Sensory deficits are prevalent in HCP and often underestimated by standard clinical assessments.
- These sensory deficits are suggested to underlie predictive motor control impairments.
- Children with HCP show some capacity for predictive control, though impaired in the more affected hand.
Conclusions:
- Sensory impairments significantly impact prehension and motor control in children with hemiplegic cerebral palsy.
- Neurorehabilitation strategies should integrate sensory and motor interventions.
- Therapeutic approaches, including intensive practice and utilizing the less affected limb, can improve motor control in the more affected limb.
Abstract:
Children with hemiplegic cerebral palsy (HCP) exhibit long-term functional deficits. One of the most debilitating is the loss of prehension since this may impair functional independence. This loss of prehension could be partly due to sensory deficits. Identifying the underlying causes of prehension deficits and their potential link with sensory disorders is important to better adapt neurorehabilitation. Here we provide an overview of precision grip and sensory impairments in individuals with HCP, and the relation between them, in order to determine whether the sensory impairments influence the type and magnitude of deficits as measured by studies of prehensile force control. Pubmed and Scopus databases were used to search studies from 1990 to 2012, using combinations of the following keywords: fingertip force; grip force; precision grip; sensory deficit; sensory impairment; tactile discrimination; with cerebral palsy. Of the 190 studies detected through the systematic search; 38 were finally included in the systematic part of this review. This review shows that sensory deficits are common and are likely underestimated using standard clinical assessments in HCP. Some studies suggest these deficits are the basis of predictive motor control impairments in these individuals. However, children with HCP retain some ability to use predictive control, even if it is impaired in the more affected hand. Intensive practice and initial use of the less affected hand, which has only subtle sensory deficits, has been shown to remediate impairments in anticipatory motor control during subsequent use of the more affected hand. Implications for motor and sensory rehabilitation of individuals with HCP are discussed.
