Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers.
Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers.
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DOI：
10.1177/1545968317739997
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发表时间：
2017-10
影响因子：
4.2
通讯作者：
Gillick BT
中科院分区：
文献类型：
--
作者：
Rich TL;Menk JS;Rudser KD;Feyma T;Gillick BT
单侧脑性瘫痪（UCP）儿童的神经康复干预针对日常生活中的运动能力，但手部技能的缺陷仍然存在。受影响较小的手的限制可能会影响整体双手的手技能。通过Jebsen-Taylor手功能测试（JTTHF）的定时运动表现和握力，比较UCP儿童与8-18岁典型发育（CTD）儿童的手功能。探索性分析比较了手功能测量与经颅磁刺激测量的神经生理学结果以及半球运动阈值的组间比较。对47名儿童（21名UCP; 26名CTD）的基线手技能进行了评估。单脉冲经颅磁刺激试验评估皮质脊髓束和运动阈值。在JTTHF上，UCP儿童的较少受累手与CTD儿童的优势手的平均差异为21.4秒[95%置信区间= 9.32，33.46，p=0.001]。握力的平均差异为−30.8 N [−61.9，0.31，p = 0.052]。各组之间的静息运动阈值不显著，但年龄与RMT显著相关（p<0.001; p=0.001）。UCP同侧运动表征模式的儿童比对侧运动表征模式的儿童表现出更大的平均差异（p<0.001）。根据年龄和性别调整所有结果。UCP儿童的较少影响的手表现低于CTD的优势手。UCP同侧运动模式的儿童限制更大。受影响较小的手可能需要康复。在未来的研究中，双侧手功能可能有助于确定最佳的康复和神经调节干预。
Neurorehabilitation interventions in children with unilateral cerebral palsy (UCP) target motor abilities in daily life yet deficits in hand skills persist. Limitations in the less-affected hand may impact overall bimanual hand skills. To compare hand function, by timed motor performance on the Jebsen-Taylor Test of Hand Function (JTTHF) and grip strength of children with UCP to children with typical development (CTD), ages 8–18 years old. Exploratory analyses compared hand function measures with respect to neurophysiological outcomes measured by transcranial magnetic stimulation and between group comparisons of hemispheric motor threshold. Baseline hand skills were evaluated in 47 children (21 UCP; 26 CTD). Single-pulse transcranial magnetic stimulation testing assessed corticospinal tract and motor threshold. The mean difference of the less-affected hand of children with UCP to the dominant hand of CTD on the JTTHF was 21.4 seconds [95% Confidence Interval = 9.32, 33.46, p=0.001]. The mean difference in grip strength was −30.8 N [−61.9, 0.31, p = 0.052]. Resting motor thresholds between groups were not significant, but age was significantly associated with RMT (p<0.001; p=0.001). Children with UCP ipsilateral pattern of motor representation demonstrated greater mean differences between hands than children with contralateral pattern of motor representation (p<0.001). All results adjusted for age and sex. The less-affected hand in children with UCP underperformed the dominant hand of CTD. Limitations were greater in children with UCP ipsilateral motor pattern. Rehabilitation in the less-affected hand may be warranted. Bilateral hand function in future studies may help identify the optimal rehabilitation and neuromodulatory intervention.
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影响因子：
2.9
作者：
Kwon HG;Son SM;Jang SH
通讯作者：
Jang SH
影响因子：
3.8
作者：
Carr, LJ
通讯作者：
Carr, LJ
影响因子：
3.8
作者：
Juenger, Hendrik;Kuhnke, Nicola;Mall, Volker
通讯作者：
Mall, Volker
健康儿童神经运动发育的皮质相关性
影响因子：
4.7
作者：
Garvey, MA;Ziemann, U;Wassermann, EM
通讯作者：
Wassermann, EM
DOI：
10.1111/j.1469-8749.2009.03496.x
发表时间：
2010-02-01
影响因子：
3.8
作者：
Holmstrom, Linda;Vollmer, Brigitte;Eliasson, Ann-Christin
通讯作者：
Eliasson, Ann-Christin