Article

This study explores the relationship between unimanual capacity and bimanual
performance for children with congenital hemiplegia aged 5 to 16 years. It also
examines the relationship between impairments and unimanual capacity and bimanual
performance. METHOD: Participants in this cross-sectional study attended a
screening assessment before participating in a large, randomized trial. They
comprised 70 children with congenital hemiplegia (39 males, 31 females; mean age
10 y 6 mo, SD 3 y); 18 were classified in the Manual Ability Classification
System level I, 51 in level II, and one in level III. Eighteen were in Gross
Motor Function Classification System, level I and 52 in level II. Sixty-five
participants had spasticity and five had dystonia and spasticity. Fifteen
typically developing children (7 males, 8 females; mean age 8 y 8 mo, SD 2 y 7
mo), matched to study participants for age and sex, were recruited as a
comparison group for measures of sensation, grip strength, and movement
efficiency. Outcome measures for unimanual capacity were the Melbourne Assessment
of Unilateral Upper Limb Function (MUUL), and the Jebsen-Taylor Hand Function
Test (JTHFT). The Assisting Hand Assessment (AHA) evaluated bimanual performance.
Upper limb impairments were measured using assessments of stereognosis, moving
two-point discrimination, spasticity, and grip strength. RESULTS: There was a
strong relationship between unimanual capacity (MUUL) and bimanual performance
(AHA; r=0.83). Linear regression indicated MUUL and stereognosis accounted for
75% of the variance in AHA logit scores. Sensory measures were moderately
correlated with unimanual capacity and bimanual performance. Age, sex, and grip
strength did not significantly influence bimanual performance. There was no
difference between children with right- and left-sided hemiplegia for motor
performance. INTERPRETATION: Findings of our study confirm a strong relationship
between unimanual capacity and bimanual performance in a cohort of children with
congenital hemiplegia. However, the directionality of the relationship is unknown
and therapists cannot assume improvements in unimanual capacity will lead to
gains in bimanual performance.

Langue : ANGLAIS