Acknowledgments This study was funded by the Norwegian Directorate of Health. We thank Rannei Sæther and Torarin Lamvik for providing study participants, Tom Ivar Lund Nilsen for statistical advice, and Brian Hopkins for English editing.
Relationship between neuromuscular body functions and upper extremity activity in children with cerebral palsy
Article first published online: 7 OCT 2009
© The Authors. Journal compilation © Mac Keith Press 2009
Developmental Medicine & Child Neurology
Volume 52, Issue 2, pages e29–e34, February 2010
How to Cite
BRÆNDVIK, S. M., ELVRUM, A.-K. G., VEREIJKEN, B. and ROELEVELD, K. (2010), Relationship between neuromuscular body functions and upper extremity activity in children with cerebral palsy. Developmental Medicine & Child Neurology, 52: e29–e34. doi: 10.1111/j.1469-8749.2009.03490.x
- Issue published online: 15 JAN 2010
- Article first published online: 7 OCT 2009
- PUBLICATION DATA Accepted for publication 24th July 2009. Published online.
Aim Our aim was to investigate the relationship between the dimensions of neuromuscular body function and elbow, forearm, and hand activity in the upper extremities in children/adolescents with spastic cerebral palsy (CP), within the framework of the World Health Organization International Classification of Functioning, Disability and Health.
Method Twenty-three participants (10 males, 13 females, mean age 13y, SD 3y, range 8–18y) with spastic CP (21 with hemiplegia, two with diplegia) at Manual Ability Classification System levels I to III participated in the study. Neuromuscular body function measures were (1) muscle strength in the elbow, forearm, and grip, (2) muscle tone in elbow flexors and forearm supinators, (3) active supination range and elbow extension range, and (4) force control at submaximal level in elbow flexion. Activity measures were actual use of the affected hand in bimanual activities (Assisting Hand Assessment) and instructed use of the affected hand (Melbourne Assessment of Unilateral Upper Limb Function).
Results Nearly all the neuromuscular body function variables were significantly correlated with activity. The combination of active supination range and strength explained 74% of the variance in actual use, and the combination of active supination range and force control explained 74% of the variance in instructed use.
Interpretation In high-functioning children and adolescents with CP, limited active supination range and difficulties in generating and modulating force are strongly related to limitations in hand activity. Further studies are needed to establish cause and effect in this relationship.