Article

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.
INTERPRETATION: In children with spastic hemiplegic cerebral palsy, bracing of
the wrist and thumb immediately improves spontaneous use of the affected upper
limb in bimanual activities, possibly because bracing permits a more functional
hand position.
CI - (c) The Authors. Journal compilation (c) Mac Keith Press 2011.

Langue : ANGLAIS