Affected and Contralateral Hand Strength and Dexterity Measures in Children With Hemiplegic Cerebral Palsy

Tomhave, Wendy; Heest, Ann E. Van; Bagley, Anita; James, Michelle A.

doi:10.1016/j.jhsa.2014.12.039

Cited by 25 publications

(10 citation statements)

References 23 publications

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“…Significant differences in the JTTHF of the less-affected hand of children with UCP as compared to the dominant hand of CTD were observed. Our observations are consistent with previous reports of deficits including kinematic differences (reliance on feedback strategies instead of feedforward programming during reaching towards a target 34 and impairments in movement duration and time to peak hand speed during reaching 35 ) and grip (subtle changes in the grip-lift movement 36 , gross manual dexterity 37 , and grip strength 37,38 ). Deficits in timed motor performance may be a target for intervention clinically and in research and warrants pursuit of a larger trial.…”

Section: Discussionsupporting

confidence: 92%

“…Deficits in timed motor performance may be a target for intervention clinically and in research and warrants pursuit of a larger trial. 23,37 …”

Section: Discussionmentioning

confidence: 99%

“…Deficits in timed motor performance may be a target for intervention clinically and in research and warrants pursuit of a larger trial. 24,37 The mean of the differences between hands observed within both groups revealed CTD have performance and strength similarities between the hands in contrast to children with UCP who display large differences between hands. In our study, CTD displayed relatively small differences between hands for grip strength and time motor performance (Table 3).…”

Section: Hand Function Measuresmentioning

confidence: 97%

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Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers

Rich

Menk

Rudser

et al. 2017

Neurorehabil Neural Repair

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Background Neurorehabilitation interventions in children with unilateral cerebral palsy (UCP) target motor abilities in daily life yet deficits in hand skills persist. Limitations in the less-affected hand may impact overall bimanual hand skills. Objective To compare hand function, by timed motor performance on the Jebsen-Taylor Test of Hand Function (JTTHF) and grip strength of children with UCP to children with typical development (CTD), ages 8–18 years old. Exploratory analyses compared hand function measures with respect to neurophysiological outcomes measured by transcranial magnetic stimulation and between group comparisons of hemispheric motor threshold. Methods Baseline hand skills were evaluated in 47 children (21 UCP; 26 CTD). Single-pulse transcranial magnetic stimulation testing assessed corticospinal tract and motor threshold. Results The mean difference of the less-affected hand of children with UCP to the dominant hand of CTD on the JTTHF was 21.4 seconds [95% Confidence Interval = 9.32, 33.46, p=0.001]. The mean difference in grip strength was −30.8 N [−61.9, 0.31, p = 0.052]. Resting motor thresholds between groups were not significant, but age was significantly associated with RMT (p<0.001; p=0.001). Children with UCP ipsilateral pattern of motor representation demonstrated greater mean differences between hands than children with contralateral pattern of motor representation (p<0.001). All results adjusted for age and sex. Conclusions The less-affected hand in children with UCP underperformed the dominant hand of CTD. Limitations were greater in children with UCP ipsilateral motor pattern. Rehabilitation in the less-affected hand may be warranted. Bilateral hand function in future studies may help identify the optimal rehabilitation and neuromodulatory intervention.

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Section: Discussionsupporting

confidence: 92%

“…Deficits in timed motor performance may be a target for intervention clinically and in research and warrants pursuit of a larger trial. 23,37 …”

Section: Discussionmentioning

confidence: 99%

Section: Hand Function Measuresmentioning

confidence: 97%

See 1 more Smart Citation

Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers

Rich

Menk

Rudser

et al. 2017

Neurorehabil Neural Repair

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“…Most children incur lifelong developmental deficits after perinatal stroke, with 80% having contralateral hemiparesis [ 3 ]. While motor impairments of the contralesional upper limb have been the primary focus in rehabilitation, studies have suggested that the “unaffected” ipsilesional limb also shows deficits in coordination, dexterity, strength, and movement speed [ 4 – 9 ]. Many activities of daily living depend on the input and coordination of both arms, therefore developing a better understanding of upper limb impairments may advance therapies and improve outcomes.…”

Section: Introductionmentioning

confidence: 99%

Bilateral reaching deficits after unilateral perinatal ischemic stroke: a population-based case-control study

Kuczynski

Kirton

Semrau

et al. 2018

J NeuroEngineering Rehabil

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BackgroundDetailed kinematics of motor impairment of the contralesional (“affected”) and ipsilesional (“unaffected”) limbs in children with hemiparetic cerebral palsy are not well understood. We aimed to 1) quantify the kinematics of reaching in both arms of hemiparetic children with perinatal stroke using a robotic exoskeleton, and 2) assess the correlation of kinematic reaching parameters with clinical motor assessments.MethodsThis prospective, case-control study involved the Alberta Perinatal Stroke Project, a population-based research cohort, and the Foothills Medical Center Stroke Robotics Laboratory in Calgary, Alberta over a four year period. Prospective cases were collected through the Calgary Stroke Program and included term-born children with magnetic resonance imaging confirmed perinatal ischemic stroke and upper extremity deficits. Control participants were recruited from the community. Participants completed a visually guided reaching task in the KINARM robot with each arm separately, with 10 parameters quantifying motor function. Kinematic measures were compared to clinical assessments and stroke type.ResultsFifty children with perinatal ischemic stroke (28 arterial, mean age: 12.5 ± 3.9 years; 22 venous, mean age: 11.5 ± 3.8 years) and upper extremity deficits were compared to healthy controls (n = 147, mean age: 12.7 ± 3.9 years). Perinatal stroke groups demonstrated contralesional motor impairments compared to controls when reaching out (arterial = 10/10, venous = 8/10), and back (arterial = 10/10, venous = 6/10) with largest errors in reaction time, initial direction error, movement length and time. Ipsilesional impairments were also found when reaching out (arterial = 7/10, venous = 1/10) and back (arterial = 6/10). The arterial group performed worse than venous on both contralesional and ipsilesional parameters. Contralesional reaching parameters showed modest correlations with clinical measures in the arterial group.ConclusionsRobotic assessment of reaching behavior can quantify complex, upper limb dysfunction in children with perinatal ischemic stroke. The ipsilesional, “unaffected” limb is often abnormal and may be a target for therapeutic interventions in stroke-induced hemiparetic cerebral palsy.

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“…Fine motor skills influence math and written expression, 1 perceived scholastic competence, 2 early numeracy performance, 3 kindergarten student attention and achievement, 4,5 and daily physical activity level. 6 Poor fine motor skills have been found in children with developmental coordination disorder, 2,7 hemiplegic cerebral palsy, 8 and obesity. 9,10 When considered the developmental aspect of fine motor skills, one study has demonstrated that poor fine motor skills at five years old might result in a delayed motor development at 15 years old.…”

Section: Supervised Physical Training Improves Fine Motor Skills Of 5-year-old Children O Treinamento Físico Supervisionado Melhora As Hamentioning

confidence: 99%

Supervised Physical Training Improves Fine Motor Skills of 5-Year-Old Children

Tan

Sui

et al. 2018

Rev Bras Med Esporte

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Introduction: Fine motor skills are important for children not only in the activities of daily living, but also for learning activities. In the present study, the effects of supervised physical training were investigated in normal children. Objective: To evaluate the effects of supervised training by combining full-body exercise and the eye-hand coordination activities to improve fine motor skills in a group of five-year-old normal children. Methods: Fifty-two children were selected and randomized in exercise and control groups. The exercise group participated in three 30-minute training sessions per week for 24 weeks. Results: The fine motor skills and hand grip strength of the exercise group were significantly increased, while there was no significant change in the control group during the experimental period. Conclusion: The results indicate that the current exercise training program is effective and can be applied to 5-year-old normal children to improve their fine motor skills. In addition, this program has simple physical activities that are appropriate to the physical and mental level of child development. The 30-minute training session would be easily implemented in the kindergarten program. Level of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

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Affected and Contralateral Hand Strength and Dexterity Measures in Children With Hemiplegic Cerebral Palsy

Cited by 25 publications

References 23 publications

Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers

Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers

Bilateral reaching deficits after unilateral perinatal ischemic stroke: a population-based case-control study

Supervised Physical Training Improves Fine Motor Skills of 5-Year-Old Children

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