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The effect of positioning on the hand function of boys with cerebral palsy
Insights
Positioning impacts hand function in boys with spastic diplegic cerebral palsy. Prone standing improved simulated feeding, while sitting enhanced picking up small objects.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pediatric Physical Therapy
Background:
- Spastic diplegic cerebral palsy (CP) affects motor control, particularly in the upper extremities.
- Understanding how different positions influence hand function is crucial for optimizing daily activities and therapeutic interventions in children with CP.
Purpose of the Study:
- To investigate the effect of two distinct body positions—sitting and prone standing—on the hand function of boys with spastic diplegic cerebral palsy.
- To assess both the rate of manipulation and the quality of grasp during specific hand tasks.
Main Methods:
- The study involved 10 boys with spastic diplegic cerebral palsy (mean age 12.5 years).
- Participants were evaluated using the Jebsen-Taylor Hand Function Test for manipulation speed and a modified Hohlstein scale for grasp quality.
- Testing was conducted twice, comparing sitting versus prone standing positions.
Main Results:
- No significant overall differences in total hand function scores were found between sitting and prone standing positions, or between test sessions.
- Significant improvements in speed were observed for the 'simulated feeding' subtest in the prone standing position.
- Conversely, the 'picking up small objects' subtest was performed significantly faster in the sitting position.
Conclusions:
- Body positioning can differentially affect specific hand function subtasks in children with spastic diplegic cerebral palsy.
- While overall hand function may not change drastically, optimizing position for specific tasks like feeding or object manipulation can enhance performance.
- These findings highlight the importance of considering task-specific positioning strategies in the rehabilitation of upper extremity function in pediatric CP.
Abstract:
The effect of positioning (sitting and prone standing) on the hand function of 10 boys (mean age = 12.5 years, SD = 1.2 years) with spastic diplegic cerebral palsy was studied. Two groups of subjects were tested twice (Tests 1 and 2) with the Jebsen-Taylor Hand Function Test (Jebsen, Taylor, Treischmann, Trotter, & Howard, 1969; Taylor, Sand, & Jebsen, 1973) to measure rate of manipulation. In addition, a scale modified from Hohlstein (1982) was used to measure quality of grasp on each subtest of the Jebsen-Taylor test. No significant differences between the mean scores of the two groups were found on the total scores of the Jebsen-Taylor test, either between Tests 1 and 2 or between sitting and prone standing. When the data from Tests 1 and 2 were combined, it was found that on one subtest--simulated feeding--the subjects performed significantly faster while in a prone standing position. On another subtest--picking up small objects--the subjects performed significantly faster while in a sitting position. Except during the simulated feeding subtest, the quality of the subjects' grasp was observed to be mature and tailored to the objects manipulated. This paper presents considerations for analyzing positioning in relation to upper extremity tasks.