Hand functioning in children with cerebral palsy.
Hand functioning in children with cerebral palsy.
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DOI：
10.3389/fneur.2014.00048
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发表时间：
2014
影响因子：
3.4
通讯作者：
Thonnard JL
中科院分区：
文献类型：
--
作者：
Arnould C;Bleyenheuft Y;Thonnard JL
脑损伤可能会干扰脑瘫儿童的手部功能，使他们很难甚至不可能进行一些体力活动。大多数常规治疗CP手部功能障碍的方法都认为，减少手部功能障碍将提高管理活动的能力（即手动能力，MA）。本研究的目的是探讨手技能影响CP儿童MA的方向关系（直接和间接途径）。共评估136例CP儿童（平均年龄：10岁，范围：6-16岁；35例四肢瘫痪，24例双瘫，77例偏瘫）。用双手测量六项手部技能：触压检测（Semmes-Weinstein触觉计）、立体感知（手形知觉测试）、本体感觉（掌指关节被动活动）、握力（Jamar测力仪）、总手敏捷度（GMD）（盒块测试）和细指敏捷度（Purdue Pegboard测试）。MA采用ABILHAND-Kids问卷进行测量。相关系数用于确定观察变量之间的线性关联。应用结构方程模型的通径分析来检验观察变量之间因果关系的不同模型。纯粹的感觉障碍似乎在进行体力活动的能力中没有发挥重要作用。通径分析发现，双手GMD和优势手立体认知与MA有直接关系，而GS通过与GMD的关系与MA有间接关系。然而，三分之一的MA测量差异不能用手工技能来解释。可以得出结论，MA不仅仅是日常活动中手部技能的整合，应该对其本身进行治疗，支持基于活动的干预措施。
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 Perception Test), 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.
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DOI：
10.1016/j.apmr.2004.10.008
发表时间：
2005-04-01
影响因子：
4.3
作者：
Gordon, AA;Charles, J;Wolf, SL
通讯作者：
Wolf, SL
影响因子：
1.9
作者：
Carlson, Michelle Gerwin;Brooks, Catherine
通讯作者：
Brooks, Catherine
影响因子：
3.8
作者：
Fedrizzi, E;Pagliano, E;Oleari, G
通讯作者：
Oleari, G
影响因子：
3.8
作者：
Gordon, AM
通讯作者：
Gordon, AM
影响因子：
5.5
作者：
Gandevia, SC;Phegan, CML
通讯作者：
Phegan, CML