Article

AIM: To describe the development of bimanual performance among young children
with unilateral or bilateral cerebral palsy (CP).
METHOD:
A population-based
sample of 102 children (53 males, 49 females), median age 28.5 months
(interquartile range [IQR] 16mo) at first assessment and 47 months (IQR 18mo) at
last assessment, was assessed half-yearly with the Assisting Hand Assessment
(AHA) or the Both Hands Assessment (BoHA) for a total of 329 assessments.
Developmental limits and rates were estimated by nonlinear mixed-effects models.
Developmental trajectories were compared between levels of manual ability
(Mini-Manual Ability Classification System [Mini-MACS] and MACS) and AHA or BoHA
performance at 18 months of age (AHA-18/BoHA-18) for both CP subgroups, and
additionally between children with bilateral CP with symmetric or asymmetric hand
use. RESULTS: For both CP subgroups, children classified in Mini-MACS/MACS level
I, and those with high AHA-18 or BoHA-18 reached the highest limits of
performance. For children with bilateral CP the developmental change was small,
and children with symmetric hand use reached the highest limits. INTERPRETATION:
Mini-MACS/MACS levels and AHA-18 or BoHA-18 distinguished between various
developmental trajectories both for children with unilateral and bilateral CP.
Children with bilateral CP changed their performance to a smaller extent than
children with unilateral CP. Manual Ability Classification
System levels and Assisting Hand Assessment/Both Hands Assessment performance at
18 months are important predictors of hand use development in cerebral palsy
(CP). Children with bilateral CP improved less than those with unilateral CP.
Children with bilateral CP and symmetric hand use reached higher limits than
those with asymmetry.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS