Bimanual coordination during a physically coupled task in unilateral spastic cerebral palsy children.
Sharah A Mutalib, Michael Mace, Etienne Burdet
PMID 30606226WHAT IT FOUND
During a two-handed lifting task, children with unilateral spastic cerebral palsy took longer, squeezed harder, and moved jerkily than typical peers, but the overall grip and lift relationship was not worse than typical peers, and they did not show excessive early grip.
Key findings
01Children with unilateral spastic cerebral palsy took approximately four times longer than typical children during the load phase (0.60 ± 0.64 s vs 0.15 ± 0.04 s; p < 0.001).
02Children with unilateral spastic cerebral palsy generated greater grasp force during lifting (9.52 ± 4.35 N vs 5.93 ± 1.40 N; p < 0.05) and had lower movement smoothness scores during ascending (-16.37 ± 0.24 vs -5.99 ± 2.66; p < 0.001).
03The overall grip and lift force relationship did not differ between groups (load: 0.40 ± 0.29 vs -0.29 ± 0.15; p = 0.2; unload: -1.72 ± 0.28 vs -1.80 ± 1.32; p = 0.92), but the force pattern was less monotonic in children with unilateral spastic cerebral palsy (load: 0.90 ± 0.20 vs 1 ± 0; p < 0.01; unload: 0.77 ± 0.25 vs 0.89 ± 0.15; p < 0.05).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only 32 children were studied, with 15 children with unilateral spastic cerebral palsy and 17 typical controls. The children with unilateral spastic cerebral palsy were selected for ability to grasp and lift with both hands and to follow instructions, so findings may not apply to children who cannot do that. No treatment was assigned, and the measured outcomes were timing, force and movement scores during a cube lift, not daily function. The analysis used medians and non-parametric tests because sample size was small and data were not normally distributed. Visual feedback was not controlled, so the paper cannot separate its effect from haptic coupling.
Declared interests
The supplied text has no conflict-of-interest or funding declaration. The publication types list non-U.S. government research support.
The easy way to misread this
Do not conclude that physically coupled bimanual training improves function. This paper compared task measurements in children with unilateral spastic cerebral palsy and typical peers; it did not assign treatment or measure ADL outcomes.