[Recovery of the "instrument-hand" and the "communication-hand" in the hemiparetic child]

Rehabilitation techniques have always attached great importance to the recovery of hand functions in the different forms of child cerebral palsy. The human hand has complex structure and functions, and it can be defined as "instrument-hand", "expression-hand", "relation-hand" and "constant challenge to rehabilitation programmes. Among the most common techniques used today, neuromuscular facilitation allows the recovery only of the instrumental function, and cortical facilitation allows only the awareness of the motor learning. The psychomotor approach is aimed at a global recovery of the gesture, i.e. at the restoration of the movement neurophysiologic, relational and interactive aspects. Aim of this paper is to evaluate the possibility of restoring the hand communicative function in children with paresis.

Ten patients (6 males and 4 females; age range 20 months-8 years) with hemiparesis not associated with other disorders undergoing psychomotor therapy were compared with 10 controls (5 males and 5 females) undergoing traditional therapy (generally following Bobath).

The communicative function of the hemiparetic hand was restored in 8 patients compared to 2 patients in the control group.

Even though our series includes few cases and it is not possible to draw any definitive conclusion, it is reasonable to hypothesize that the psychomotor approach is a therapeutic model able to restore the hand complex functions.