Related Experiment Video
Updated: Mar 15, 2026
Author Spotlight: Enhancing Upper Limb Rehabilitation in Stroke Patients Through Advanced Robotic and Neuromodulation Technologies
Published on: October 11, 2024
HIV encephalopathy with bilateral lower limb spasticity: upper limb motor function and level of activity and
Theresa N Mann1,2, Kirsten A Donald3, Barbara Laughton4
1Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
Insights
Children with HIV encephalopathy (HIVE) and bilateral lower limb (BLL) spasticity show poorer upper limb motor function and reduced participation compared to peers. Assessment of upper limb function is crucial for their care.
Area of Science:
- Pediatric neurology
- Neurorehabilitation
- Child development
Background:
- HIV encephalopathy (HIVE) can lead to neurological impairments, including spasticity.
- Bilateral lower limb (BLL) spasticity is a common complication affecting mobility in children with HIVE.
- Upper limb function, activity, and participation are critical for a child's development and quality of life.
Purpose of the Study:
- To evaluate upper limb motor function in children with HIVE and BLL spasticity.
- To assess the levels of activity and participation in this population.
- To compare outcomes with typically developing children.
Main Methods:
- A cross-sectional study involving 30 ambulant children with HIVE and BLL spasticity and 20 typically developing children (aged 5-12 years).
- Upper limb motor function was measured using the Purdue Pegboard test.
- Activity and participation levels were assessed using the Computer-Adapted Pediatric Evaluation of Disabilities Inventory (PEDI-CAT).
Main Results:
- Children with HIVE and BLL spasticity demonstrated significantly lower scores on all Purdue Pegboard tasks compared to controls (p≤0.001).
- The HIVE group also scored lower in three out of four PEDI-CAT domains, indicating reduced activity and participation (p≤0.001).
- There was substantial variability in individual outcomes within each Gross Motor Function Classification System (GMFCS) level.
Conclusions:
- Children with HIVE and BLL spasticity experience significant deficits in upper limb motor performance.
- Impaired upper limb function negatively impacts their overall activity and participation levels.
- Routine assessment of upper limb motor function should be integrated into the comprehensive care plan for children with HIVE and BLL spasticity.
Aim:
To describe upper limb motor function and level of activity and participation in children with HIV encephalopathy (HIVE) and bilateral lower limb (BLL) spasticity.
Method:
Thirty ambulant children with HIVE and BLL spasticity and 20 typically developing children, between 5 years and 12 years, were recruited. Upper limb motor function was assessed using the Purdue Pegboard and level of activity and participation using the Computer-Adapted Pediatric Evaluation of Disabilities Inventory (PEDI-CAT).
Results:
The HIVE group comprised 14 males and 16 females (mean age [SD] 8y 8mo [2y 2mo], Gross Motor Function Classification System (GMFCS) level I [n=10], II [n=11], and III [n=9]) and the typically developing group comprised 11 males and 9 females (mean age 8y 8mo [2y 3mo]). The HIVE group had lower scores than the typically developing group for all pegboard tasks and three of the four PEDI-CAT domains (p≤0.001). However, individual outcome scores varied substantially within each GMFCS level.
Interpretation:
Children with HIVE and BLL spasticity may have significantly poorer upper limb motor performance and lower levels of activity and participation than typically developing children. These findings suggest that an assessment of upper limb motor function should form part of optimal care for this population.
