| 1. |
|
|
| 2. |
|
|
| 3. |
- Holmefur, Marie, 1968-, et al.
(författare)
-
Factors that predict and correlate with development of hand function in children with unilateral cerebral palsy
- 2012
-
Ingår i: 9th COTEC Congress of Occupational Therapy.
-
Konferensbidrag (refereegranskat)abstract
- Earlier studies of development of hand function showed large variation between individuals in course of development.Aim: To identify factors that predict or correlate with development of hand function in children with unilateral cerebral palsy (CP).Methods: Forty-five children with unilateral CP (inclusion age 18-64 months) were measured repeatedly with the Assisting Hand Assessment over on average 4,5 years. Data was collected on brain lesion (n=27), learning ability, sensibility in affected hand etc. A non-linear mixed models analysis was used.Results: Type, extent and location of brain lesion could predict development of hand function. Decreased learning ability was a predictor of slower development of hand function. Poor sensibility in the affected hand correlated with slower development and a lower ability level compared to children with good sensibility.Conclusion: Development of hand function can be predicted by brain lesion and is correlated to learning ability and sensibility in the affected hand.
|
|
| 4. |
- Holmefur, Marie, 1968-, et al.
(författare)
-
Longitudinal development of hand function in children with unilateral cerebral palsy
- 2009
-
Ingår i: Developmental Medicine & Child Neurology. - West Sussex, UK : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 51:s5
-
Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives: Studies of longitudinal development of hand function in children with unilateral cerebral palsy (CP) are sparse. For children with unilateral CP the ability to use the affected hand as an effective assist to the dominant hand in bimanual tasks may be the most important aspect of hand function in daily life. This ability can be assessed with the assisting hand assessment (AHA). The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral CP between 18 months and 8 years of age.Design: This was a study of prognosis with a prospective longitudinal cohort design. Participants and Setting: Forty-three children with unilateral cerebral palsy participated (22 male, 21 female). They were recruited at local rehabilitation centres and constituted a convenience sample. Inclusion age was 18 months–5 years 4 months (mean 2 years 8 months). Manual ability classification system (MACS) levels: I [n=7], II [n=25], III [n=11].Materials/Methods: The children were assessed with the AHA over a period of at least 3 years (mean 4.5 years), with 3–11 assessments per child. Children entered the study at different ages allowing evaluation of development from ages 18 months to 8 years. Estimated average motor development curves were fitted with a non-linear mixed effects model.Results: Individual differences in development were considerable. Children with a high AHA score at 18 months (over 40 raw scores) reached a significantly higher ability level and at a higher progression rate than the children with a low 18-month AHA score. The children with high 18-month AHA score reached 90% of their limit at average age 3 years whereas the children with a low 18-month AHA score reached 90% of their maximum level at a mean age of 7. Similarly, the maximum level of development differed between children in MACS level I–III. The rate of change was similar in levels I and II and significantly slower, in level III.Conclusions/Significance: This study shows that children with different ability levels all develop their way of using their hemiplegic hand during the preschool years. The AHA can be used to follow development over time and the AHA score at 18 months can be used for approximate prediction of development of assisting hand use.
|
|
| 5. |
- Holmefur, Marie, 1968-, et al.
(författare)
-
Neuroradiology can predict the development of hand function in children with unilateral cerebral palsy
- 2013
-
Ingår i: Neurorehabilitation and Neural Repair. - : Sage Publications. - 1545-9683 .- 1552-6844. ; 27:1, s. 72-78
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Much variation is found in the development of hand function in children with unilateral cerebral palsy (CP).OBJECTIVE: To explore how anatomic brain abnormalities can be used to predict the development of hand function.METHODS: A total of 32 children with unilateral CP (16 boys and 16 girls) were evaluated at least once a year by the Assisting Hand Assessment (AHA). The data collection covered an age range from 18 months to 8 years (mean time in study, 4 years and 6 months). Computerized tomography or magnetic resonance imaging of the brain were assessed for patterns of brain damage, including the location of gray and extent of white-matter damage. The children were divided into groups according to lesion characteristics, and a series of univariate models were analyzed with a nonlinear mixed-effects model. The rate and maximum limit of development were calculated.RESULTS: The highest predictive power of better development of hand function was the absence of a concurrent lesion to the basal ganglia and thalamus, independent of the basic type of brain lesion. This model predicted both the rate of increasing ability and hand function at age 8 years. Hand function was also predicted by the basic pattern of damage and by the extent of white-matter damage. The presence of unilateral or bilateral damage had no predictive value.CONCLUSIONS: Neuroradiological findings can be used to make a crude prediction of the future development of the use of the affected hand in young children with unilateral CP.
|
|
