Children With Cerebral Palsy Show Higher Static-But Not Higher Dynamic-Motor Fatigability in Grip and Pinch Tasks Than Children With Typical Development Do.

The study used a convenience sample from schools, hospitals, and research programs in three countries, so the children may not represent all children with unilateral spastic cerebral palsy. Three invited children with unilateral spastic cerebral palsy could not complete the tests because of severe muscle weakness, and many test results had fewer than 53 children because some trials were invalid or incomplete, so the most impaired children are under-represented. Children were classified at Manual Ability Classification System levels I to III, so results may not apply to children with more severe hand function limitations. The study compared many static and dynamic outcomes in both hands, and the new force-ratio measures did not separate groups as well as the Static Fatigue Index, partly because of high variability. The design measured children at one time and did not test any intervention, so it cannot show that treatment would change fatigability or daily function. The study did not measure why fatigability occurred, such as muscle recruitment, lesion pattern, spasticity, or how fatigability affects activities of daily living. Testing occurred in different schools and countries, and two testers administered the protocol, which may have introduced small differences in how tasks were performed.

Do not conclude that children with unilateral spastic cerebral palsy have normal dynamic endurance or that repeated squeeze tasks are unaffected. The dynamic results were inconsistent, and some measures were higher in children with typical development, so the clearer finding is higher static fatigability.