ACKNOWLEDGEMENTS We wish to express our deepest gratitude to the children and families who participated in this study. We also wish to thank the occupational therapists who assisted in data collection and especially Karin Shaw reg PT MSc, who carried out the first years of data collection. We thank Ellen Romein OT MSc and Melanie Hessenauer OT for help with scoring AHA assessments. We also thank Dr Steven Hanna, Associate Professor at McMaster University, Ontario, Canada, for sharing knowledge and support in statistical dilemmas. This study was supported by the Health Care Sciences Postgraduate School at Karolinska Institutet, Swedish Research Council, Centre for Health Care Science at Karolinska Institutet, Norrbacka-Eugenia Foundation, Stockholm County Council, FoU Committee, and Sällskapet Barnavård.
Longitudinal development of hand function in children with unilateral cerebral palsy
Article first published online: 3 JUL 2009
© The Authors. Journal compilation © Mac Keith Press 2009
Developmental Medicine & Child Neurology
Volume 52, Issue 4, pages 352–357, April 2010
How to Cite
HOLMEFUR, M., KRUMLINDE-SUNDHOLM, L., BERGSTRÖM, J. and ELIASSON, A.-C. (2010), Longitudinal development of hand function in children with unilateral cerebral palsy. Developmental Medicine & Child Neurology, 52: 352–357. doi: 10.1111/j.1469-8749.2009.03364.x
- Issue published online: 4 MAR 2010
- Article first published online: 3 JUL 2009
- PUBLICATION DATA Accepted for publication 2nd April 2009. Published online 3rd July 2009.
Aim The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years.
Method A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y 8mo [SD 1y 1mo]). Children were assessed with the Assisting Hand Assessment (AHA) 3 to 11 times per child over a mean period of 4 years 6 months. Two models were used for grouping children: by AHA score at 18 months and by Manual Ability Classification System (MACS) levels. Estimated average motor development curves were fitted with a nonlinear mixed-effects model.
Results Children with a high AHA score (high ability level) at 18 months reached a significantly higher ability level and at a higher progression rate than children with a low 18-month AHA score. Limits of development differed between the three MACS levels.
Interpretation Results indicate that the AHA score at 18 months can be used to discuss future development of affected hand use in bimanual tasks in children with unilateral CP.