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Hand Function in Cerebral Palsy. Report of 367 Children in a Population-Based Longitudinal Health Care Program

Arner, Marianne LU ; Eliasson, A. -C.; Nicklasson, S.; Sommerstein, K. and Hägglund, Gunnar LU (2008) In Journal of Hand Surgery 33A(8). p.1337-1347
Abstract
Purpose To describe aspects of hand function in a total population of children with cerebral palsy (CP). Methods Upper extremity data were collected for 367 children who were born between 1992 and 2001 and were registered in a population-based health care program for children with CP. Hand function was classified according to the Manual Ability Classification System (MACS), the House functional classification, and the Zancolli classification. The type of spastic thumb-in-palm deformity was evaluated according to House. Results In the total population of children with CP aged 4 to 14 years, 60% had more than minor problems with hand function (>MACS I). Independence in age-relevant, daily manual activities (MACS I-II) was noted in 87% of... (More)
Purpose To describe aspects of hand function in a total population of children with cerebral palsy (CP). Methods Upper extremity data were collected for 367 children who were born between 1992 and 2001 and were registered in a population-based health care program for children with CP. Hand function was classified according to the Manual Ability Classification System (MACS), the House functional classification, and the Zancolli classification. The type of spastic thumb-in-palm deformity was evaluated according to House. Results In the total population of children with CP aged 4 to 14 years, 60% had more than minor problems with hand function (>MACS I). Independence in age-relevant, daily manual activities (MACS I-II) was noted in 87% of children with spastic unilateral CP and in 63% of children with spastic bilateral CP, but in only 20% of children with dyskinetic CP. According to the House functional classification, both hands were spontaneously and independently used in 55% of children (House 7-8), whereas 5% did not use either of their hands (House 0). Minor increase of flexor muscle tone (Zancolli level 1) was found in 69% of all children. Only 2% were in level 3 in both hands. Spastic thumb-in-palm deformity in 1 hand was found in 25% and in both hands in another 15%. Conclusions Limitations in hand function are common in all types of CP, but characteristics of the disability vary considerably between different CP subtypes. The MACS classification is useful to evaluate how well children can handle objects in daily activities. The House functional classification describes grip function in each hand separately; the Zancolli classification of finger and wrist extension and the classification of thumb-in-palm deformity according to House give an estimate of dynamic spasticity. All these classifications were shown to be useful in a population-based health care program, but further studies of the psychometric properties are required. (J Hand Surg 2008;33A:1337-1347. Copyright (C) 2008 by the American Society for Surgery of the Hand. All rights reserved.) (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
children, Hand function, cerebral palsy, total population
in
Journal of Hand Surgery
volume
33A
issue
8
pages
1337 - 1347
publisher
Elsevier
external identifiers
  • wos:000260049100012
  • scopus:53249142517
ISSN
1531-6564
DOI
10.1016/j.jhsa.2008.02.032
language
English
LU publication?
yes
id
b0b97bc8-58a6-4020-b11f-c26b7cf3c127 (old id 1284897)
date added to LUP
2009-02-06 11:27:35
date last changed
2017-07-09 03:58:08
@article{b0b97bc8-58a6-4020-b11f-c26b7cf3c127,
  abstract     = {Purpose To describe aspects of hand function in a total population of children with cerebral palsy (CP). Methods Upper extremity data were collected for 367 children who were born between 1992 and 2001 and were registered in a population-based health care program for children with CP. Hand function was classified according to the Manual Ability Classification System (MACS), the House functional classification, and the Zancolli classification. The type of spastic thumb-in-palm deformity was evaluated according to House. Results In the total population of children with CP aged 4 to 14 years, 60% had more than minor problems with hand function (>MACS I). Independence in age-relevant, daily manual activities (MACS I-II) was noted in 87% of children with spastic unilateral CP and in 63% of children with spastic bilateral CP, but in only 20% of children with dyskinetic CP. According to the House functional classification, both hands were spontaneously and independently used in 55% of children (House 7-8), whereas 5% did not use either of their hands (House 0). Minor increase of flexor muscle tone (Zancolli level 1) was found in 69% of all children. Only 2% were in level 3 in both hands. Spastic thumb-in-palm deformity in 1 hand was found in 25% and in both hands in another 15%. Conclusions Limitations in hand function are common in all types of CP, but characteristics of the disability vary considerably between different CP subtypes. The MACS classification is useful to evaluate how well children can handle objects in daily activities. The House functional classification describes grip function in each hand separately; the Zancolli classification of finger and wrist extension and the classification of thumb-in-palm deformity according to House give an estimate of dynamic spasticity. All these classifications were shown to be useful in a population-based health care program, but further studies of the psychometric properties are required. (J Hand Surg 2008;33A:1337-1347. Copyright (C) 2008 by the American Society for Surgery of the Hand. All rights reserved.)},
  author       = {Arner, Marianne and Eliasson, A. -C. and Nicklasson, S. and Sommerstein, K. and Hägglund, Gunnar},
  issn         = {1531-6564},
  keyword      = {children,Hand function,cerebral palsy,total population},
  language     = {eng},
  number       = {8},
  pages        = {1337--1347},
  publisher    = {Elsevier},
  series       = {Journal of Hand Surgery},
  title        = {Hand Function in Cerebral Palsy. Report of 367 Children in a Population-Based Longitudinal Health Care Program},
  url          = {http://dx.doi.org/10.1016/j.jhsa.2008.02.032},
  volume       = {33A},
  year         = {2008},
}