PTOTOtherDevelopmental medicine and child neurology2018

The Tyneside Pegboard Test: development, validation, and observations in unilateral cerebral palsy.

Anna P Basu, Emma V Kirkpatrick, Blythe Wright and 3 others

PMID 29247458

WHAT IT FOUND

The Tyneside Pegboard Test measures bimanual coordination separately from hand speed.

In children with unilateral cerebral palsy, bimanual scores correlate with affected-hand function, while dominant-hand speed does not. This test identifies coordination deficits that single-hand assessments miss.

Key findings

01In children with unilateral cerebral palsy, bimanual completion times correlated strongly with Affected-Hand AHA scores (r=0.63) and non-dominant hand times (r=0.69), but not with dominant hand times (r=0.025).

02Children with unilateral cerebral palsy showed a larger difference between bimanual and unimanual completion times (20.31s) compared to typical development, indicating specific bimanual coordination difficulties beyond simple hand slowness.

03Successful completion of the bimanual task in children with unilateral cerebral palsy was associated with an AHA score of 39 or above, ability to grasp and release, and willingness to engage.

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 normative data is cross-sectional, so age-related changes may be influenced by cohort effects rather than true development. A learning effect was observed in the bimanual task, meaning two baseline assessments are recommended before starting an intervention. The study did not directly measure cognitive or sensory factors that might influence bimanual performance. Reference ranges for left-handed individuals were not established due to small sample sizes in that subgroup.

The easy way to misread this

Do not assume that a child with unilateral cerebral palsy has normal dominant-hand function based on a good TPT dominant-hand score. The study found that dominant-hand speed did not correlate with affected-hand function (AHA), meaning a fast dominant hand can mask significant bimanual coordination deficits. Always interpret the bimanual and non-dominant hand scores together.

Read it on PubMed →