Hand function in children with hemiplegic cerebral palsy: prospective follow‐up and functional outcome in adolescence

Fedrizzi, Ermellina; Pagliano, Emanuela; Andreucci, Elena

doi:10.1111/j.1469-8749.2003.tb00910.x

Cited by 127 publications

(84 citation statements)

References 20 publications

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“…[26][27][28] The remaining 12 papers were either intervention trials or longitudinal studies that had used a bimanual assessment tool to evaluate children with hemiplegic CP within the desired age range. 13,14,[29][30][31][32][33][34][35][36][37][38] A second search for evidence of validity, reliability, and clinical utility of the identified assessments for the specified diagnosis and age range found no further study.…”

Section: Database Searchmentioning

confidence: 99%

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Assessing bimanual performance in young children with hemiplegic cerebral palsy: a systematic review

Greaves

Imms

Dodd

et al. 2010

Develop Med Child Neuro

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AIM This systematic review investigated the availability of assessment tools to evaluate bimanual skills in young children (£ 3y) with hemiplegic cerebral palsy. Evidence for validity, reliability, and clinical utility of the identified instruments was sought.METHOD Ten electronic databases and grey literature were searched (earliest 1806) to February 2009 to identify articles that met criteria related to the child's age and diagnosis, and included a discrete bimanual assessment. Further searches for evidence of psychometric properties of each identified assessment were undertaken. For quality criteria, we evaluated the internal validity of each study and appraised the validity and reliability of identified assessments.RESULTS From 1435 papers retrieved, 15 were eligible for inclusion, and 11 assessments of bimanual performance were identified. Ten assessments had inadequate evidence for reliability and validity. Only the Assisting Hand Assessment had evidence for reliability and validity for its intended purposes.INTERPRETATION Reliability and validity are fundamental considerations when developing or selecting assessments. Additional considerations for assessing young children include the following: (1) standardized administration and scoring; (2) items that capture the complexity of bimanual behaviour; and (3) protocols and items targeted within a small age range to meet specific developmental needs. A validated assessment of younger infants is needed to support early intervention during this period of rapid brain development.

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Section: Database Searchmentioning

confidence: 99%

“…All three papers were of a high methodological quality (reliability 10 ⁄ 12; validity 3 to 3½ ⁄ 4). Enough information was reported in a longitudinal study 29 to provide primary evidence for the reliability of Fedrizzi, i.e. the authors described a pilot study conducted to evaluate the interrater agreement of the tool.…”

Section: Quality Assessmentmentioning

confidence: 99%

Assessing bimanual performance in young children with hemiplegic cerebral palsy: a systematic review

Greaves

Imms

Dodd

et al. 2010

Develop Med Child Neuro

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“…Cerebral palsy (CP) is the most prevalent form of physical disability in children (1), occurring in 1 out of 303 live births (). Almost 50% of children with CP present an arm–hand dysfunction (2, 3). Children with unilateral spastic CP seldom use their paretic hand spontaneously in daily activities (2, 4).…”

Section: Introductionmentioning

confidence: 99%

Hand Functioning in Children with Cerebral Palsy

2014

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Brain lesions may disturb hand functioning in children with cerebral palsy (CP), making it difficult or even impossible for them to perform several manual activities. Most conventional treatments for hand dysfunction in CP assume that reducing the hand dysfunctions will improve the capacity to manage activities (i.e., manual ability, MA). The aim of this study was to investigate the directional relationships (direct and indirect pathways) through which hand skills influence MA in children with CP. A total of 136 children with CP (mean age: 10 years; range: 6–16 years; 35 quadriplegics, 24 diplegics, 77 hemiplegics) were assessed. Six hand skills were measured on both hands: touch-pressure detection (Semmes–Weinstein esthesiometer), stereognosis (Manual Form Perception Test), proprioception (passive mobilization of the metacarpophalangeal joints), grip strength (GS) (Jamar dynamometer), gross manual dexterity (GMD) (Box and Block Test), and fine finger dexterity (Purdue Pegboard Test). MA was measured with the ABILHAND-Kids questionnaire. Correlation coefficients were used to determine the linear associations between observed variables. A path analysis of structural equation modeling was applied to test different models of causal relationships among the observed variables. Purely sensory impairments did seem not to play a significant role in the capacity to perform manual activities. According to path analysis, GMD in both hands and stereognosis in the dominant hand were directly related to MA, whereas GS was indirectly related to MA through its relationship with GMD. However, one-third of the variance in MA measures could not be explained by hand skills. It can be concluded that MA is not simply the integration of hand skills in daily activities and should be treated per se, supporting activity-based interventions.

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“…For QUEST there was a peak at about age 4 years and a decline that was more marked in children with lowest ability. Fedrizzi et al 14 specifically studied children with unilateral CP and investigated both grip pattern and spontaneous hand use by means of nonstandardized assessments. They found no change over time in spontaneous hand use, but a slight improvement in the quality of grip at ages 4 to 7 years, which declined after 11 years of age in a subgroup with low ability.…”

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confidence: 99%

Longitudinal development of hand function in children with unilateral cerebral palsy

Holmefur

Krumlinde‐Sundholm

Bergström

et al. 2010

Develop Med Child Neuro

127

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AIM The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years.METHOD A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y 8mo [SD 1y 1mo]). Children were assessed with the Assisting Hand Assessment (AHA) 3 to 11 times per child over a mean period of 4 years 6 months. Two models were used for grouping children: by AHA score at 18 months and by Manual Ability Classification System (MACS) levels. Estimated average motor development curves were fitted with a nonlinear mixed-effects model. RESULTSChildren with a high AHA score (high ability level) at 18 months reached a significantly higher ability level and at a higher progression rate than children with a low 18-month AHA score. Limits of development differed between the three MACS levels.INTERPRETATION Results indicate that the AHA score at 18 months can be used to discuss future development of affected hand use in bimanual tasks in children with unilateral CP.Development of hand skills in typically developing children is characterized by a rapidly increasing ability during early years followed by a refinement of these skills until adolescence. 1-3The course of typical development has been thoroughly investigated and there are several norm-referenced tests. 4,5 Characteristically, children with unilateral cerebral palsy (CP) have one well-functioning hand and one impaired hand.6 Common features of the hemiplegic hand are slowness, abnormal muscle tone, decreased strength, and coordination difficulties, which occur to a varying extent in children independently of age. 7Many children also have impaired sensibility and mirror movements. 8,9 Perhaps most importantly, children with unilateral CP have varying degrees of limitation in their ability to handle objects in daily life. This limitation is most obvious in situations where two hands are needed. 10 However, knowledge about bimanual ability in children with unilateral CP and its development over time is scarce at present. Information on this development would be useful when discussing treatment planning and prognosis for development with the families.Development is best investigated in longitudinal studies in which the same individuals are measured repeatedly over time. Longitudinal studies are time-consuming, but they provide a unique way to follow the course of change in individuals and explore differences in development between individuals.11 An already classic example of motor development curves based on longitudinal observations of children with CP was given in 2002 by Rosenbaum et al. 12 in the area of gross motor function. They found distinctly different development of gross motor function for children in all five levels of the Gross Motor Function Classification System (GMFCS). This knowledge can be used to predict the rate and limitation of development in young children at different G...

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Hand function in children with hemiplegic cerebral palsy: prospective follow‐up and functional outcome in adolescence

Cited by 127 publications

References 20 publications

Assessing bimanual performance in young children with hemiplegic cerebral palsy: a systematic review

Assessing bimanual performance in young children with hemiplegic cerebral palsy: a systematic review

Hand Functioning in Children with Cerebral Palsy

Longitudinal development of hand function in children with unilateral cerebral palsy

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