Hand Function in a Population-Based Sample of Young Children with Unilateral or Bilateral Cerebral Palsy
Gunvor L Klevberg1, Sigrid Østensjø2, Lena Krumlinde-Sundholm3
1a Research Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society , University of Oslo , Oslo , Norway.
Insights
This study assessed hand function in young children with cerebral palsy (CP). Children with bilateral CP showed more varied manual abilities, highlighting the need for tailored interventions.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) affects motor function, with hand function being crucial for daily activities.
- Understanding hand function variations in young children with CP is essential for early intervention.
- Population-based data provide valuable insights into the spectrum of CP hand impairments.
Purpose of the Study:
- To characterize hand function in a population-based cohort of young children diagnosed with unilateral or bilateral CP.
- To analyze manual abilities and bimanual hand use in relation to CP type and age.
- To evaluate the utility of established and novel assessment tools for young children with CP.
Main Methods:
- Cross-sectional study utilizing Norwegian national CP register data.
- Manual Ability Classification System (MACS) and Mini-MACS were used for manual ability classification.
- Assisting Hand Assessment (AHA) for unilateral CP and Both Hands Assessment (BoHA) for bilateral CP measured bimanual hand use.
Main Results:
- Included 128 children (mean age 30.4 months) with unilateral or bilateral CP (MACS/Mini-MACS levels I-V).
- Significant variations in hand function (AHA/BoHA units) were observed within both unilateral and bilateral CP groups.
- Higher manual ability and older age correlated with improved hand function scores (p < 0.01 and p < 0.04, respectively).
Conclusions:
- Children with bilateral CP exhibited greater variability in manual ability levels compared to those with unilateral CP.
- Both unilateral and bilateral CP groups demonstrated wide ranges in bimanual hand function.
- The assessed tools effectively differentiate ability levels, informing personalized upper limb interventions for children with CP.
Aim:
To describe aspects of hand function in a population-based sample of young children with clinical signs of unilateral or bilateral cerebral palsy (CP).
Method:
A cross-sectional study with data from national CP registers in Norway. Manual ability was classified with the Manual Ability Classification System (MACS) or Mini-MACS. Hand use in bimanual activities was measured with the Assisting Hand Assessment (AHA) for unilateral CP or the newly developed Both Hands Assessment (BoHA) for bilateral CP.
Results:
From 202 children, 128 (57 females) were included (Mini-MACS/MACS levels I-V, mean age 30.4 months; SD = 12.1). Manual abilities were distributed across levels I-III in unilateral CP and levels I-V in bilateral CP. Variations in AHA and BoHA units were large. One-way ANOVA revealed associations between higher AHA or BoHA units and Mini-MACS/MACS levels of higher ability (p < 0.01) and higher age (p < 0.04).
Conclusions:
Compared with young children with unilateral CP, children with bilateral CP showed greater variation in Mini-MACS/MACS levels, and both sub-groups showed large variations in AHA or BoHA units. The classifications and assessments used in this study are useful to differentiate young children's ability levels. Such information is important to tailor upper limb interventions to the specific needs of children with CP.
