Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers.
Tonya L Rich, Jeremiah S Menk, Kyle D Rudser and 2 others
PMID 29130382WHAT IT FOUND
Children with hemiparetic cerebral palsy took 21.4 seconds longer on hand function tests with their less-affected hand compared to typical peers.
This subtle deficit suggests therapists should assess and treat the less-affected hand, not just the weaker one.
Key findings
01The less-affected hand of children with unilateral cerebral palsy showed significantly slower performance on functional tasks compared to the dominant hand of typically developing children.
02Grip strength differences between the less-affected hand of children with cerebral palsy and the dominant hand of typically developing children did not reach statistical significance.
03Children with an ipsilateral motor pattern showed larger differences between their two hands in both speed and strength compared to those with a contralateral pattern.
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
Small sample size, particularly when stratified by motor pattern (only 6 children with ipsilateral pattern). No adjustment for multiple comparisons was made, increasing the risk of false positives. Some children with UCP were tested at a lower maximum stimulator output (85%) due to concurrent clinical trial participation, which may have affected motor threshold detection. The study did not assess mixed motor patterns, so some children categorized as contralateral may have had bilateral representation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that grip strength is significantly impaired in the less-affected hand. The observed difference of 30.8 newtons was not statistically significant (p = 0.052), whereas the speed deficit was.