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Hand functioning in children with cerebral palsy.

Carlyne Arnould1, Yannick Bleyenheuft2, Jean-Louis Thonnard3

  • 1Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole Louvain en Hainaut , Charleroi , Belgium.

Frontiers in Neurology
|May 1, 2014
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Summary
This summary is machine-generated.

In children with cerebral palsy (CP), gross manual dexterity and stereognosis directly impact manual ability. Grip strength influences manual ability indirectly, but hand skills don't fully explain functional capacity.

Keywords:
activities of daily livingbody functionscerebral palsydexterityhandmanual abilitypath analysisrelationships

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Area of Science:

  • Neurology
  • Pediatrics
  • Rehabilitation Medicine

Background:

  • Children with cerebral palsy (CP) often experience impaired hand function due to brain lesions, affecting their ability to perform daily activities.
  • Conventional treatments for CP hand dysfunction focus on improving specific hand impairments to enhance overall manual ability (MA).

Purpose of the Study:

  • To investigate the direct and indirect pathways through which various hand skills influence manual ability (MA) in children with cerebral palsy.
  • To understand the relationship between specific hand skills and functional performance in children with CP.

Main Methods:

  • Assessed 136 children with CP (ages 6-16) using standardized tests for six hand skills: sensory detection, stereognosis, proprioception, grip strength, gross manual dexterity, and fine finger dexterity.
  • Utilized the ABILHAND-Kids questionnaire to measure manual ability (MA).
  • Employed correlation coefficients and path analysis via structural equation modeling to analyze relationships between hand skills and MA.

Main Results:

  • Gross manual dexterity (GMD) in both hands and stereognosis in the dominant hand showed direct relationships with manual ability (MA).
  • Grip strength (GS) was indirectly related to MA, mediated by its association with GMD.
  • Sensory impairments alone did not significantly predict manual ability.
  • Hand skills explained only two-thirds of the variance in manual ability, indicating other factors are involved.

Conclusions:

  • Manual ability (MA) in children with cerebral palsy (CP) is not solely a summation of individual hand skills.
  • Activity-based interventions that address MA directly are crucial, as hand skills do not fully account for functional capacity.
  • Further research is needed to explore the unexplained variance in MA.