• Carlyne Arnould, Massimo Penta, and Jean-Louis Thonnard.
• Laboratory of Rehabilitation and Physical Medicine, Universite catholique de Louvain, Bruxelles, Belgium.
• J Rehabil Med. 2007 Nov 1; 39 (9): 708-14.

ObjectiveTo study hand impairments and their relationship with manual ability in children with cerebral palsy.DesignCross-sectional survey.PatientsA total of 101 children with cerebral palsy (mean age 10 years, age range 6-15 years) were assessed.MethodsThree motor and 3 sensory impairments were measured on both hands. Motor impairments included grip strength (Jamar dynamometer), gross manual dexterity(Box and Block Test) and fine finger dexterity (Purdue Peg-board Test). Sensory impairments included tactile pressure detection (Semmes-Weinstein aesthesiometer), stereognosis(Manual Form Perception Test) and proprioception (passive mobilization of the metacarpophalangeal joints). Manual ability was measured with the ABILHAND-Kids questionnaire. The relationship between hand impairments and manual ability was studied through correlation coefficients and a multiple linear forward stepwise regression analysis.ResultsMotor impairments were markedly more prevalent than sensory ones. Gross manual dexterity on the dominant hand and grip strength on the non-dominant hand were the best independent predictors of the children's manual ability,predicting 58% of its variance.ConclusionHand impairments and manual ability are not related in a predictable straightforward relationship. It is important that, besides hand impairments, manual ability is also measured and treated, as it is not simply the integration of hand functions in daily activities.

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