Somatosensory discrimination impairment in children with hemiplegic cerebral palsy as measured by the sense_assess© <i>kids</i>

McLean, Belinda; Taylor, Susan; Valentine, Jane; Thornton, Ashleigh; Elliott, Catherine

doi:10.1111/1440-1630.12729

Cited by 7 publications

(5 citation statements)

References 39 publications

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“…Beyond their motor problems, at least 80 percent of children with uCP present with additional somatosensory or visual impairments. 23,25,26 Moreover, it is well-known that sensory input is a key cornerstone for planning and netuning motor actions. 27,28 Indeed, previous studies have already reported on the relation between increased somatosensory de cits and reduced bimanual function in children with uCP.…”

Section: Discussionmentioning

confidence: 99%

Spatiotemporal coordination in children with unilateral cerebral palsy: insights from a bimanual goal-directed task

Mailleux,

Decraene,

Kalkantzi

et al. 2023

Preprint

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Background: In children with unilateral cerebral palsy (uCP), bimanual assessments mostly focus on qualitative assessments of the impaired upper limb during bimanual tasks, which do not capture the spatiotemporal coordination between both hands. Hence, we aimed to advance our understandings in spatiotemporal coordination in children with uCP compared to typically developing children (TDC) using a bimanual goal-directed task. Participants and methodology: In this observational study, thirty-seven children with uCP (11y8m±2y10m, 20 males, 16 right-sided uCP, Manual Ability Classification System level I=23, II=11, III=3) and 37 age and sex-matched TDC opened a box with one hand and pressed a button inside using the opposite hand. Spatiotemporal bimanual (movement time, temporal coupling, movement overlap, goal synchronisation) and unimanual (movement time, path length and smoothness) parameters were extracted. Between groups comparisons were investigated using a two-way mixed ANCOVA with age as covariate (α<0.05). Additionally, correlation coefficients between unimanual and bimanual parameters were calculated. Results: Compared to TDC, children with uCP did not differ in bimanual coupling relative to their movement time (p>0.31, ηp2<0.03). However, they were slower (p=0.01, ηp2=0.13) and presented with unimanual spatiotemporal deficits bilaterally (p<0.03, ηp2>0.10), which worsened in children with lower manual abilities (p<0.04, ηp2>0.19). Moreover, slower movement time was related with increased unimanual spatiotemporal deficits bilaterally (r=0.34-0.80, p<0.001-0.04), suggesting that reduced performance at both sides contributes to bimanual difficulties in children with uCP. Conclusions: The bilateral reduced spatiotemporal coordination, related to longer bimanual movement time, stresses the importance to assess and treat both upper limbs in children with uCP.

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Section: Discussionmentioning

confidence: 99%

Spatiotemporal coordination in children with unilateral cerebral palsy: insights from a bimanual goal-directed task

Mailleux,

Decraene,

Kalkantzi

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…The results from this study showing sensory deficits in the upper extremity across the cohort of adults with CP and a spastic diplegic presentation were somewhat surprising given that those with diplegia are assumed to exclusively have lower extremity impairments. This may be due to the strength of the WPST to distinguish deficits in position sense in clinical populations ( 42 , 68 , 69 ), but also may reflect an inadequate clinical picture of those with a diplegic presentation. The current findings indicate that hand proprioceptive acuity is diminished in adults with CP, building on past studies that have revealed similar deficits across the lifespan ( 13 – 15 , 55 , 56 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, the number of studies related to proprioception in this population remains very low (11). Further investigation of the source and timing of these sensory deficits in people with CP may reveal effective targets for therapeutic intervention, as suggested in prior studies (15,69,70). The relationship of these sensory deficits to the extent of the upper extremity motor control challenges in individuals with CP across the lifespan remains an important area for further study.…”

Section: Sensory Function In Adults With Cpmentioning

confidence: 99%

Reduced wrist flexor H-reflex excitability is linked with increased wrist proprioceptive error in adults with cerebral palsy

et al. 2022

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Although most neurophysiological studies of persons with cerebral palsy (CP) have been focused on supraspinal networks, recent evidence points toward the spinal cord as a central contributor to their motor impairments. However, it is unclear if alterations in the spinal pathways are also linked to deficits in the sensory processing observed clinically. This investigation aimed to begin to address this knowledge gap by evaluating the flexor carpi radialis (FCR) H-reflex in adults with CP and neurotypical (NT) controls while at rest and during an isometric wrist flexion task. The maximal H-wave (Hmax) and M-wave (Mmax) at rest were calculated and utilized to compute Hmax/Mmax ratios (H:M ratios). Secondarily, the facilitation of the H-wave was measured while producing an isometric, voluntary wrist flexion contraction (i.e., active condition). Finally, a wrist position sense test was used to quantify the level of joint position sense. These results revealed that the adults with CP had a lower H:M ratio compared with the NT controls while at rest. The adults with CP were also unable to facilitate their H-reflexes with voluntary contraction and had greater position sense errors compared with the controls. Further, these results showed that the adults with CP that had greater wrist position sense errors tended to have a lower H:M ratio at rest. Overall, these findings highlight that aberration in the spinal cord pathways of adults with CP might play a role in the sensory processing deficiencies observed in adults with CP.

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“…Children and adolescents with uCP present with motor and somatosensory impairments predominantly at one side of the body, which are often more pronounced in the upper compared to the lower limb [9]. Although CP has been primarily defined as a motor disorder, previous research has shown that up to 90% of the children and adolescents with uCP also present with impairments in one or more modalities of somatosensation [10][11][12].…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

Does somatosensory discrimination therapy alter sensorimotor upper limb function differently compared to motor therapy in children and adolescents with unilateral cerebral palsy: study protocol for a randomized controlled trial

Kleeren,

Mailleux,

McLean

et al. 2023

Preprint

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Background: Besides motor impairments, up to 90% of the children and adolescents with unilateral cerebral palsy (uCP) present with somatosensory impairments in the upper limb. As somatosensory information is of utmost importance for coordinated movements and motor learning, somatosensory impairments can further compromise the effective use of the impaired upper limb in daily life activities. Yet, intervention approaches specifically designated to target these somatosensory impairments are insufficiently investigated in children and adolescents with uCP. Therefore, the aim of this randomized controlled trial (RCT) is to compare the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP, who experience somatosensory impairments in the upper limb. We will further explore potential behavioral and neurological predictors of therapy response. Methods: A parallel group, evaluator-blinded, phase-II, single centre RCT will be conducted for which 50 children and adolescents with uCP, aged 7 to 15 years, will be recruited. Participants will be randomized to receive 3 weekly sessions of 45 minutes of either somatosensory discrimination therapy or upper limb motor therapy for a period of 8 weeks. Stratification will be performed based on age, manual ability and severity of tactile impairment at baseline. Sensorimotor upper limb function will be evaluated at baseline, immediately after the intervention and after 6 months follow-up. The primary outcome measure will be bimanual performance as measured with the Assisting Hand Assessment. Secondary outcomes include a comprehensive test battery to objectify somatosensory function and measures of bimanual coordination, unimanual motor function and goal attainment. Brain imaging will be performed at baseline to investigate structural brain lesion characteristics and structural connectivity of the white matter tracts. Discussion: This protocol describes the design of an RCT comparing the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP. The results of this study may aid in the selection of the most effective upper limb therapy, specifically for children and adolescents with tactile impairments. Trial registration: ClinicalTrials.gov (NCT06006065). Registered on August 8, 2023.

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Somatosensory discrimination impairment in children with hemiplegic cerebral palsy as measured by the sense_assess© kids

Cited by 7 publications

References 39 publications

Spatiotemporal coordination in children with unilateral cerebral palsy: insights from a bimanual goal-directed task

Spatiotemporal coordination in children with unilateral cerebral palsy: insights from a bimanual goal-directed task

Reduced wrist flexor H-reflex excitability is linked with increased wrist proprioceptive error in adults with cerebral palsy

Does somatosensory discrimination therapy alter sensorimotor upper limb function differently compared to motor therapy in children and adolescents with unilateral cerebral palsy: study protocol for a randomized controlled trial

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