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Correlation Between Standard Upper Extremity Impairment Measures and Activity-based Function Testing in Upper

Michelle A James1, Anita Bagley, James B Vogler

  • 1*Shriners Hospitals for Children-Northern California, Sacramento, CA †School of Medicine, University of South Florida, Tampa, FL ‡Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.

Journal of Pediatric Orthopedics
|July 16, 2015
PubMed
Summary

Impairment measures like range of motion (ROM) inconsistently predict function in children with upper extremity cerebral palsy (UECP). Activity measures may better guide surgical decisions for UECP treatment.

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Area of Science:

  • Pediatric Orthopedics
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Standard surgical indications for upper extremity cerebral palsy (UECP) rely on impairment measures, mainly range of motion (ROM).
  • Recent development of validated activity measures for UECP offers new assessment tools.
  • Functional improvement, encompassing activity and participation, is the ultimate goal of UECP treatment.

Purpose of the Study:

  • To investigate the relationship between impairment and activity measures in children with UECP.
  • To determine if different activity measures correlate with each other in this population.

Main Methods:

  • 37 children (ages 5-16) with UECP underwent evaluation using active/passive ROM, stereognosis, Assisting Hand Assessment (AHA), Box and Blocks test, and SHUEE DPA.
  • Spearman rank correlation coefficients were used to analyze the relationship between impairment and activity measures.

Main Results:

  • Impairment measures showed inconsistent correlations with activity measures.
  • Active forearm supination, wrist extension, and stereognosis correlated with AHA; wrist extension correlated with SHUEE DPA.
  • Activity measures demonstrated correlations: AHA with Box and Blocks, and SHUEE DPA with Box and Blocks.

Conclusions:

  • Impairment measures, including ROM, do not reliably predict functional capacity for activities in UECP.
  • Activity limitation measures show promise as more relevant indicators for guiding upper extremity surgery in UECP.
  • Correlations between activity measures suggest potential for combined use in assessing functional status.