Contra-Lateral Unintended Upper Arm Movement during Unimanual Tasks in Children with Cerebral Palsy
Seung Ki Kim1, Han Kyul Park1, Eun Sook Park2
1Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Insights
Children with cerebral palsy (CP) exhibit associated reactions (ARs) in their non-task arm during unimanual tasks. Age and upper limb function influence the severity of these motor overflow responses.
Area of Science:
- Neuroscience
- Pediatric Rehabilitation
- Movement Science
Background:
- Associated reactions (ARs) are involuntary movements in the non-affected limb during voluntary movement of the affected limb.
- Understanding ARs in children with cerebral palsy (CP) is crucial for developing targeted interventions.
- Previous research has primarily focused on ARs in adults or gross motor tasks.
Purpose of the Study:
- To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks in children with CP.
- To identify factors associated with the presence and severity of ARs in this population.
Main Methods:
- Prospective, cross-sectional study involving 35 children with CP.
- Assessment of ARs during three unimanual tasks (fist clench/open, finger opposition, finger tapping).
- Utilized surface electromyography (SEMG) to measure muscle activity in the non-task arm and evaluated upper limb function using the Manual Ability Classification System and Melbourne Assessment 2 (MA-2).
Main Results:
- AR scores were significantly higher in the more-affected limb compared to the less-affected limb.
- SEMG revealed motor overflow extending to elbow muscles in the more-affected limb of children with ARs.
- Age and upper limb functional status (MA-2) were identified as significant predictors of ARs in the more-affected limb.
Conclusions:
- Visible ARs in children with CP during unimanual tasks indicate motor overflow into the non-task limb.
- Age and the degree of upper limb functional impairment are key factors influencing the extent of ARs in the more-affected limb.
Purpose:
To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks and to identify factors related to ARs in children with cerebral palsy (CP).
Materials And Methods:
This was a prospective, cross-sectional study of 35 children with CP. The extent of ARs of the contra-lateral, non-task hand was assessed while performing three unimanual tasks (opening and clenching the fist, a finger opposition task, and tapping fingers). The occurrence of ARs in each trial was evaluated separately for each task using a four-point scale (total scores ranged from 0 to 12). Surface electromyography (SEMG) was used to measure the firing activity of the muscles of the opposite arm during the task. The Manual Ability Classification System and Melbourne Assessment 2 (MA-2) were used to evaluate upper limb function.
Results:
AR scores were higher in the more-affected limb than in the less-affected limb. SEMG data on the non-task hand showed motor overflow up to the elbow muscles in the more-affected limb. Root mean square ratios of EMG signals were significantly higher in children with ARs than in children without ARs. Multiple regression analysis showed both age and MA-2 to be significant factors related to ARs in the more-affected limb.
Conclusion:
Children with visible ARs showed motor overflow in the non-task limb during unimanual hand tasks. Age and upper limb function were significantly related to the extent of ARs in the more-affected limb of children with CP.
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