Immediate effect of a wrist and thumb brace on bimanual activities in children with hemiplegic cerebral palsy

Abstract

AHA Assisting Hand AssessmentAIM The aim of this study was to determine the immediate effect of wearing a wrist and thumb brace on the performance of bimanual activities in children with spastic hemiplegic cerebral palsy.METHOD In a pre-and post-test cohort study of 25 children (age range 4-11y; mean age 8y 4mo[SD 2y 2mo]; 16 males, 9 females) with spastic hemiplegic cerebral palsy with a Zancolli classification hand score of I, IIA, or IIB (mild and moderate hand dysfunction; children with a Zancolli classification of III -severe hand dysfunction -were excluded from this study), performance of bimanual activities was evaluated with the Assisting Hand Assessment (AHA) on three occasions: one assessment with a static wrist and thumb brace placed on the affected hand and two other assessments without a brace. The differences between AHA scores obtained at the three assessments were evaluated using the repeated measures analysis of variance.RESULTS Performance of bimanual activities while wearing the brace improved significantly compared to performance without the brace (p<0.001). With the brace, the mean AHA score increased by 3.2 (95% confidence interval 2.1-4.3) from 59.1 to 62.3. The scores of the two assessments without the brace did not differ significantly.

Listening to the patient as a possible route to cost-effective rehabilitation: a case report

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Upper limb function in everyday life of children with cerebral palsy: description and review of parent report measures

“…Clinical measures such as the Quality of Upper Extremity Skills Test [1] and Melbourne Assessment 2 [2] capture upper limb capacity in clinical environments, or children's best ability to use their upper limb. Children with cerebral palsy, however, are less likely to spontaneously involve their affected upper limb during play or self-care tasks in everyday environments than during clinic-based assessment or therapy sessions [3].…”

Effectiveness of functional hand splinting and the cognitive orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols

“…Preliminary evidence suggests that functional hand splints may have an immediate positive effect on hand function [18], and provide a supplementary effect to goal directed training [19]. Whilst splints may provide a very small clinical effect, it is unclear whether this leads to any improvement in function [13], and evidence suggests this immediate improvement may not be maintained beyond the splint-wearing period [13].…”

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