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Bimanual Coordination in Children with Bilateral Cerebral Palsy: A Cross-Sectional Study
Grace-Anne M Herard1,2, Ya-Ching Hung3, Marina B Brandao4
1Doctorate of Physical Therapy Program, University of St. Augustine for Health Sciences, Coral Gables, FL, USA.
Insights
Children with bilateral cerebral palsy (BCP) exhibit impaired bimanual coordination, performing tasks more slowly and sequentially. Improved coordination is linked to better hand function in both affected and unaffected hands.
Area of Science:
- Neuroscience
- Pediatrics
- Rehabilitation Medicine
Background:
- Bilateral cerebral palsy (BCP) significantly impacts motor control and coordination.
- Understanding bimanual coordination deficits is crucial for targeted interventions in children with BCP.
- Typical development (TD) provides a benchmark for assessing motor skill acquisition.
Purpose of the Study:
- To compare bimanual coordination between children with BCP and TD.
- To investigate the correlation between bimanual coordination and clinical hand function measures in children with BCP.
Main Methods:
- Collected 3-D kinematic data from 14 children with BCP and 14 age-matched TD children performing a bimanual task.
- Assessed task performance at self-paced and maximal speeds, varying hand roles.
- Classified hand function using the Manual Ability Classification System and evaluated dexterity with the Box and Blocks Test and Both Hands Assessment.
Main Results:
- Children with BCP demonstrated significantly slower and more sequential bimanual performance compared to TD peers.
- Faster task speeds, especially when the less affected hand initiated the action, improved bimanual coordination timing.
- Bimanual coordination showed significant correlations with all assessed clinical measures of hand function.
Conclusions:
- Task speed and hand role significantly influence bimanual coordination in children with BCP.
- Enhanced bimanual coordination in children with BCP is associated with less severe impairment across both hands.
- Findings highlight the importance of considering task dynamics and bilateral hand involvement in rehabilitation strategies.
Aim:
To compare bimanual coordination in children with bilateral cerebral palsy (BCP) with that of children with typical development (TD) and correlate bimanual coordination with clinical measures of hand function.
Methods:
3-D kinematic data were collected from 14 children with BCP (mean age 13 years 1 month; range 7.3-17.2 years, 5 females) and 14 age-matched children with TD (mean age 13 years 1 month, range 7.0-16.0 years, 7 females) as they opened a drawer with one hand and activated a switch inside it with the other hand at self-paced and as-fast-as-possible speeds. Hand roles varied in each condition. Participants' hand function levels were classified using the Manual Ability Classification System. Unimanual dexterity and bimanual performance were evaluated using the Box and Blocks Test and Both Hands Assessment respectively.
Results:
Participants with BCP performed the bimanual task more slowly (p < 0.001) and sequentially, as evidenced by greater time differences between the two hands achieving the end goal (p = 0.01). Faster speeds, particularly when the less affected hand opened the drawer, facilitated time-related measures of bimanual coordination (p < 0.05). Bimanual coordination correlated with all clinical measures of hand function (p < 0.05).
Conclusion:
For children with BCP, speed and hand used for each subcomponent of the task influence bimanual coordination. Better bimanual coordination is associated with less impairment of both hands.
