Deficits in Upper-Limb Task Performance in Children With Hemiplegic Cerebral Palsy as Defined by 3-Dimensional Kinematics
Presented in part to the Gait and Clinical Movement Analysis Society, April 2005, Portland, OR.
Abstract
Mackey AH, Walt SE, Stott NS. Deficits in upper-limb task performance in children with hemiplegic cerebral palsy as defined by 3-dimensional kinematics.
Objective
To define upper-limb movement deficits in children with hemiplegia using 3-dimensional (3-D) kinematic analysis of functional tasks.
Design
Cohort study.
Setting
University gait laboratory.
Participants
Ten children with hemiplegic cerebral palsy (mean age, 13.3y; range, 10–17y) and 10 control children (mean age, 9.8y; range, 6–12y).
Interventions
Not applicable.
Main Outcome Measure
3-D upper-limb movement analysis.
Results
3-D kinematics detected clinically significant between-group differences. Children with hemiplegia were significantly slower than control children in time taken to complete tasks (P<.05) and achieved slower movement velocities (P<.05). Group differences in range of motion (ROM) occurred in all 3 tasks examined (hand to mouth, hand to head, reach). Children with hemiplegia had significantly less supination (P<.03) and shoulder flexion (P<.03) and increased compensatory trunk flexion (P<.01) compared with control data (hand-to-mouth task). The reach task highlighted restriction of elbow extension in children with hemiplegia (minimum elbow extension: hemiplegia, 24±18°; control, 3±7°). Completing tasks bilaterally did not alter performance of the tasks in children with hemiplegia.
Conclusions
3-D kinematics detected deficits in timing, ROM, and proximal compensatory strategies during upper-limb functional task performance in children with hemiplegia.
aDepartment of Surgery, University of Auckland, Auckland, New Zealand.
bDepartment of Sport and Exercise Science, University of Auckland, Auckland, New Zealand.
Reprint requests to Anna H. Mackey, PhD, Dept of Surgery, University of Auckland, Private Bag 92019, Auckland, New Zealand
Supported by the Decade of Bone and Joint and the Neurological Foundation, New Zealand.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT