Arm and hand function in children with unilateral cerebral palsy: A one-year follow-up study
Arm and hand function in children with unilateral cerebral palsy: A one-year follow-up study
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DOI：
10.1016/j.ejpn.2011.08.001
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发表时间：
2012-05-01
影响因子：
3.1
通讯作者：
Molenaers, Guy
中科院分区：
文献类型：
--
作者：
Klingels, Katrijn;Feys, Hilde;Molenaers, Guy
背景：在患有单侧脑瘫（CP）的儿童中，手臂和手部功能的发育常常受到潜在的运动和感觉障碍的影响。然而，有关该人群手臂和手功能演变的知识有限。目的：目的是绘制单侧 CP 儿童一年内上肢测量得分的演变情况，并确定影响时间趋势的因素。方法：对 81 名儿童（43 名男性，38 名女性；平均年龄 9 岁 11 个月（SD 3 岁 3 岁）范围 5-15 岁）在基线、6 个月和 12 个月时进行了测试。根据国际功能、残疾和健康分类，身体功能测量包括被动运动范围、肌张力、手动肌肉力量和握力。活动测量包括墨尔本评估、捷成泰勒测试、辅助手评估和 Abilhand-Kids 问卷。使用混合模型对年龄、性别、病因（先天性或后天性病变）和手动能力分类系统 (MACS) 水平作为预测因素进行分析。 结果：握力 (p = 0.001) 和手动灵巧度（捷成泰勒检验，p < 0.0001）的得分随着时间的推移显着增加。 MACS 水平 (p = 0.03) 和病因 (p = 0.02) 对 Jebsen Taylor 评分的时间演变有显着影响。其他评估未显示显着变化。结论：除了与年龄相关的握力变化外，双手任务中的运动障碍、运动质量和偏瘫手的使用在一年内不会自发改善。然而，观察到手动灵活性有所改善，这表明一些孩子可以学习更多适应性运动策略。 (C) 2011 年欧洲小儿神经病学协会。由爱思唯尔有限公司出版。保留所有权利。
Background: In children with unilateral cerebral palsy (CP), development of arm and hand function is often compromised by the underlying motor and sensory impairments. However, knowledge about the evolution of arm and hand function in this population is limited.Aim: The aims were to map the evolution of scores on upper limb measures over one year in children with unilateral CP and to identify factors that influence time trends.Methods: Eighty-one children (43 males, 38 females; mean age 9y11mo (SD 3y3mo) range 5-15 y) were tested at baseline, at 6 and 12 months. According to the International Classification of Functioning, Disability and Health, body function measurements included passive range of motion, muscle tone, manual muscle strength and grip strength. Activity measurements included the Melbourne Assessment, the Jebsen Taylor test, the Assisting Hand Assessment and the Abilhand-Kids questionnaire. Age, gender, etiology (congenital or acquired lesions) and Manual Ability Classification System (MACS) levels were analyzed as predictive factors, using mixed models.Results: Scores for grip strength (p = 0.001) and manual dexterity (Jebsen Taylor test, p < 0.0001) increased significantly over time. MACS level (p = 0.03) and etiology (p = 0.02) had a significant influence on the time evolution of the Jebsen Taylor scores. Other assessments showed no significant changes.Conclusion: Motor impairments, movement quality and hemiplegic hand use in bimanual tasks do not spontaneously improve over one year, except for an age-related change in grip strength. However, an improvement was observed in manual dexterity, suggesting that some children can learn more adaptive movement strategies. (C) 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.