• Katrijn Klingels, Hilde Feys, Liesbet De Wit, Ellen Jaspers, Ann Van de Winckel, Geert Verbeke, Paul De Cock, and Guy Molenaers.
• Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Heverlee, Belgium. Katrijn.Klingels@faber.kuleuven.be
• Eur. J. Paediatr. Neurol. 2012 May 1; 16 (3): 257-65.

BackgroundIn children with unilateral cerebral palsy (CP), development of arm and hand function is often compromised by the underlying motor and sensory impairments. However, knowledge about the evolution of arm and hand function in this population is limited.AimThe aims were to map the evolution of scores on upper limb measures over one year in children with unilateral CP and to identify factors that influence time trends.MethodsEighty-one children (43 males, 38 females; mean age 9y11mo (SD 3y3mo) range 5-15 y) were tested at baseline, at 6 and 12 months. According to the International Classification of Functioning, Disability and Health, body function measurements included passive range of motion, muscle tone, manual muscle strength and grip strength. Activity measurements included the Melbourne Assessment, the Jebsen-Taylor test, the Assisting Hand Assessment and the Abilhand-Kids questionnaire. Age, gender, etiology (congenital or acquired lesions) and Manual Ability Classification System (MACS) levels were analyzed as predictive factors, using mixed models.ResultsScores for grip strength (p = 0.001) and manual dexterity (Jebsen-Taylor test, p < 0.0001) increased significantly over time. MACS level (p = 0.03) and etiology (p = 0.02) had a significant influence on the time evolution of the Jebsen-Taylor scores. Other assessments showed no significant changes.ConclusionMotor impairments, movement quality and hemiplegic hand use in bimanual tasks do not spontaneously improve over one year, except for an age-related change in grip strength. However, an improvement was observed in manual dexterity, suggesting that some children can learn more adaptive movement strategies.Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

18 keywords...

hide…