PTOTCase-ControlNeurorehabilitation and neural repair2023

Children With Bilateral Cerebral Palsy Exhibit Bimanual Asymmetric Motor Deficits and EEG Evidence of Dominant Sensorimotor Hemisphere Overreliance During Reaching.

Connor Phillips, Julia Kline, Christopher J Stanley and 2 others

PMID 37644730

WHAT IT FOUND

Children with bilateral cerebral palsy showed slower, curved reaches and poor hand dexterity with both hands, worse on the non-dominant side.

EEG revealed the dominant brain hemisphere worked harder than normal during these movements.

Key findings

01Children with bilateral CP transferred significantly fewer blocks on the Box and Blocks Test with both hands compared to controls, indicating substantial impairment in manual dexterity.

02Reaching movements were slower and took a longer, more curved path with the non-dominant hand in children with bilateral CP, while typical development showed no such asymmetry between hands.

03EEG data showed greater beta band activity in the dominant sensorimotor hemisphere for both hands in children with bilateral CP, suggesting an overreliance on one side of the brain during movement.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The sample size was small (15 with CP, 13 controls), which limits the generalizability of the findings. The CP group included children with different etiologies (preterm birth with periventricular leukomalacia and full-term birth with spastic or dystonic CP), so the results may not apply uniformly across all types of bilateral CP. The study only examined reaching and grasping tasks, so findings may not extend to other functional motor activities. EEG has limited spatial resolution, so the precise location of brain activity differences cannot be fully determined.

Declared interests

The study was supported by the National Institutes of Health, Intramural Research Program. No other conflicts of interest were reported.

The easy way to misread this

Do not assume that bilateral CP results in symmetric hand deficits. The study found that the non-dominant hand was significantly worse than the dominant hand, and this asymmetry was a key finding in both motor performance and brain activation patterns.

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