Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy

Klingels, Katrijn, Demeyere, Inge, Jaspers, Ellen, De Cock, Paul, Molenaers, Guy, Boyd, Roslyn and Feys, Hilde (2012) Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy. European Journal of Paediatric Neurology, 16 5: 475-484. doi:10.1016/j.ejpn.2011.12.008

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Author Klingels, Katrijn
Demeyere, Inge
Jaspers, Ellen
De Cock, Paul
Molenaers, Guy
Boyd, Roslyn
Feys, Hilde
Title Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy
Journal name European Journal of Paediatric Neurology   Check publisher's open access policy
ISSN 1090-3798
1532-2130
Publication date 2012-09-01
Sub-type Article (original research)
DOI 10.1016/j.ejpn.2011.12.008
Volume 16
Issue 5
Start page 475
End page 484
Total pages 10
Place of publication London, United Kingdom
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Background: Insights in upper limb impairments and their relationship with activity measures in children with unilateral cerebral palsy (CP) are important to optimize treatment interventions.
Aims: (1) To investigate upper limb impairments and activity limitations in children with unilateral CP; (2) to compare these according to the Manual Ability Classification System (MACS), timing of lesion (congenital/acquired) and age; (3) to determine the impact of impairments on activity measures.
Methods: Eighty-one children with unilateral CP aged 5–15 years (mean 9 years 11 months; congenital N = 69, acquired N = 12) were recruited. Body function measurements included passive range of motion (PROM), muscle tone, strength and sensibility. At activity level, the Melbourne Assessment, Assisting Hand Assessment (AHA) and Abilhand-Kids were assessed.
Results: Most PROM limitations were found for elbow extension and supination. Increased tone and weakness were most prominent in distal muscles. Stereognosis and two-point discrimination were mostly affected. Children with a lower MACS level or acquired lesion had significantly more impairments and activity limitations. In children with congenital lesions, best predictors for unimanual capacity (Melbourne Assessment) were wrist strength, stereognosis and proprioception, and for bimanual performance (AHA) wrist strength and grip strength, explaining 76% of the variance. For the Abilhand-Kids, wrist strength and stereognosis predicted 46% of the variance.
Conclusions: Classification according to MACS and timing of lesion is important to differentiate within the wide range of impairments and activity limitations. In children with congenital lesions, unimanual capacity and bimanual performance are highly determined by distal strength, supporting the additional use of impairment-based interventions.
Keyword Upper limb
Cerebral palsy
Impairments
Activity limitations
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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