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Affected and contralateral hand strength and dexterity measures in children with hemiplegic cerebral palsy
Wendy A Tomhave1, Ann E Van Heest1, Anita Bagley1
1Shriners Hospital for Children-Twin Cities, Minneapolis, MN; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN; Motion Analysis Laboratory, Shriners Hospital for Children-Northern California, Sacramento, CA; Department of Orthopaedic Surgery, University of California, Davis, School of Medicine, Sacramento, CA.
Insights
Children with hemiplegic cerebral palsy have weaker affected hands and reduced dexterity in both hands. Even the unaffected hand shows lower dexterity, suggesting potential therapeutic targets.
Area of Science:
- Pediatric neurology
- Rehabilitation medicine
- Motor control research
Background:
- Hemiplegic cerebral palsy (CP) primarily affects motor function on one side of the body.
- Hand function is crucial for daily activities and independence in children.
- The impact on the non-affected (contralateral) hand in hemiplegic CP is not fully understood.
Purpose of the Study:
- To compare grip strength, pinch strength, and dexterity of the affected and contralateral hands in children with hemiplegic CP.
- To evaluate these hand functions against age-matched normative values.
Main Methods:
- 37 children with hemiplegic CP (average age 9.8 years) participated.
- Grip strength, pinch strength, and the Box and Blocks Test for dexterity were measured in both hands.
- Data were analyzed and compared between affected and contralateral hands, and against normative data.
Main Results:
- Affected hands showed significantly lower grip and pinch strength compared to contralateral hands.
- Dexterity was significantly reduced in the affected hand (mean 10.8 blocks/min) versus the contralateral hand.
- Affected-side strengths were below norms, contralateral strengths were similar to norms, but dexterity was reduced in both hands, correlating with nonverbal IQ in the contralateral hand.
Conclusions:
- Children with hemiplegic CP exhibit diminished dexterity in their contralateral hand.
- This finding suggests that the contralateral hand may also be impacted, presenting opportunities for therapeutic interventions.
- Assessing the contralateral hand is important for comprehensive treatment planning in pediatric hemiplegic CP.
Purpose:
To determine how the affected hemiplegic hand and contralateral dominant hand in children with hemiplegic cerebral palsy compare with age-matched norms for grip strength, pinch strength, and dexterity.
Methods:
We enrolled 37 children with hemiplegic cerebral palsy (26 boys; average age, 9.8 y). Grip and pinch strength and Box and Blocks Test for dexterity were measured in both hands. Affected and contralateral hands results were analyzed and compared with each other and with norms for age and sex.
Results:
Affected hands had significantly less grip and pinch strength than the contralateral hands. Subjects transported significantly fewer blocks in one minute with the Box and Blocks Test (mean, 10.8 blocks) with the affected hand than the contralateral hand. Compared with normative values, affected-side grip and pinch strengths were significantly less, whereas contralateral hand grip and pinch strengths were similar. Dexterity in both affected and contralateral hands was significantly less than normative values. Decreased dexterity in the contralateral hand was correlated with decreased nonverbal intelligence quotient.
Conclusions:
Dexterity of the contralateral hand is diminished in children with hemiplegia. Assessment of the contralateral hand may reveal opportunities for therapeutic intervention that improve fine motor function.
Type Of Study/Level Of Evidence:
Therapeutic IV.
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