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Related Experiment Videos

Hand function in subjects with spina bifida

W J Muen1, C M Bannister

  • 1Department of Neurosurgery, Booth Hall Children's Hospital, Blackley, Manchester, UK.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|March 13, 1998
PubMed
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Children with meningomyelocele exhibit impaired hand function, including reduced muscle strength and fine motor skills. These deficits are linked to cerebellar and cervical cord abnormalities, not solely hydrocephalus or intellectual impairment.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Orthopedics

Background:

  • Meningomyelocele is a complex congenital condition often associated with neurological deficits.
  • Hand function impairments are common in individuals with meningomyelocele, but confounding factors like low IQ and cerebral palsy complicate assessment.
  • The specific impact of Arnold-Chiari malformation and cervical cord dysraphism on hand function requires further elucidation.

Purpose of the Study:

  • To evaluate the influence of Arnold-Chiari malformation, cervical cord dysraphism, and hydrocephalus on hand function in children with meningomyelocele.
  • To isolate the effects of these specific neurological conditions from other common confounding factors.
  • To compare hand function in children with meningomyelocele and shunted hydrocephalus against isolated shunted hydrocephalus and healthy controls.

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Main Methods:

  • A comparative study involving three groups: meningomyelocele with shunted hydrocephalus (n=21), isolated shunted hydrocephalus (n=13), and normal controls (n=18).
  • Subjects attended mainstream schools and underwent basic neurological examination of upper limbs.
  • A comprehensive battery of hand function tests assessed motor control, coordination, and muscle strength.

Main Results:

  • Subjects with meningomyelocele demonstrated significantly weaker hand muscle strength compared to controls and those with isolated hydrocephalus (p=0.01).
  • Poorer fine motor control and coordination were observed in the meningomyelocele group.
  • The meningomyelocele group performed significantly worse on all dominant hand tests (p=0.0003) and most non-dominant hand tests (p=0.0005) compared to controls.

Conclusions:

  • Children with meningomyelocele exhibit poorer hand function than healthy controls, independent of hydrocephalus, low IQ, or cerebral pathology.
  • Cerebellar and cervical cord abnormalities are significant factors contributing to upper limb dysfunction in this population.
  • These findings highlight the critical role of specific central nervous system malformations in hand function deficits.