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Hand Functioning in Children with Cerebral Palsy

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Arnould, Carlyne [Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole de Louvain en Hainaut, Charleroi, Belgique] Bleyenheuft, Yannick [UCL] Thonnard, Jean-Louis [UCL]

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 PerceptionTest), 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.

Type de document Article de périodique (Journal article) – Article de recherche
Type d'accès Accès libre
Année de publication 2014
Langue Anglais
Information sur le périodique "Frontiers in Neurology" - Vol. 5, p. 48 [1-10] (2014)
Peer reviewed oui
Editeur Frontiers Media ((Switzerland) Lausanne)
e-issn 1664-2295
Statut de la publication Publié
Affiliations UCL - SSS/IONS/COSY - Systems & cognitive Neuroscience
UCL - (SLuc) Service de médecine physique et de réadaptation motrice
Louvain Bionics - Center of Interdisciplinary Expertise
Mots-clés cerebral palsy ; hand ; manual ability ; activities of daily living ; body functions ; dexterity ; path analysis ; relationships
Liens
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Référence bibliographique Arnould, Carlyne ; Bleyenheuft, Yannick ; Thonnard, Jean-Louis. Hand Functioning in Children with Cerebral Palsy. In: Frontiers in Neurology, Vol. 5, p. 48 [1-10] (2014)
Permalien http://hdl.handle.net/2078.1/143337