Fifteen-minute consultation: Management of the upper limb in unilateral cerebral palsy

Abstract

Children with unilateral cerebral palsy (UCP) have complex health, education and social care needs. Delayed gross motor milestones are the most common presenting feature, and much of the early management focuses on gross motor skills and lower limb management. In later childhood, adolescence and adulthood, upper limb function has significant impact on activity, participation and independence. There is clear pathophysiological rationale and emerging clinical evidence that earlier intervention to improve upper limb function is beneficial. Whereas most children with UCP are managed in secondary care, it is recommended that the assessment and delivery of specialist intervention for the upper limb occurs at a regional centre.

Efficacy of Kinesiotape to Improve Upper-Extremity Function in Children and Adolescents with Cerebral Palsy: A Systematic Review

“…There is a correlation between manual dexterity, described in the Manual Ability Classification System (MACS), and general mobility, locomotion, communication, socialization and personal care [3]. Impairments in the upper extremity (UE) are a major factor for activity limitation and participation restriction in individuals with CP and may affect up to 50% of CP subjects [4,5]. UE limitations are mostly due to a lack of trunk control, decrease in shoulder girdle motor control and imbalance between spastic and paretic muscles [6].…”

“…That makes it difficult for people with CP to perform UE-specific tasks, such as reaching, grasping and manipulation [4], and it leads to the significant involvement of the positioning and functioning of the elbows, wrists and hands [7]. Moreover, a lack of autonomy and dependence on other people may affect the individuals' quality of life [4][5][6].…”