Relation between capacities and bimanual performance in hemiplegic cerebral palsied children : impact os synkinesis
Dr Emmanuelle CHALEAT-VALAYERa, Mrs Rachel BARDa, Dr Jean Claude BERNARDa
Objective: To analyse the link between unimanual capacities and bimanual performance in cerebral-palsied (CP) hemiplegic children, aged between 5 and 18 years old, studying specifically the impact of synkinesis.
Material and methods: 71 CP hemiplegic children (35 boys and 36 girls, mean age 8,5 years; MACS levels from I to III; GMFCS from I to IV) took part in a transversal study, assessed -Melbourne Test (MUUL) for unimanual capacities, and Assisting Hand Assessment (AHA) for bimanual performance - with a specific scale to analyze synkinesis during Box and Block test for affected and healthy hands, collecting synkinesis type, duration and intensity.
Results: there is a strong correlation between unimanual capacities (MUUL) and bimanual performance (AHA) (r=0.871). Neither age nor gender contribute to bimanual performance (AHA). Multiple linear regression shows that MUUL contributes to bimanual performance variance (AHA) by 70%. Synkinesis partly correlated to capacities (MUUL) and accounts for 10% of the variance of the gap between capacities and bimanual performance.
Conclusion: a high relationship between unimanual capacities and bimanual performance is confirmed by this study; some authors demonstrated impact of sensory troubles (1), we demonstrate that synkinesis influences the use of unimanual capacities in bimanual performance.
1 -Auld M, Boyd R, Moseley L, Ware R, Johnston L. Impact of Tactile Dysfunction on Upper-LimbMotor Performance in ChildrenwithUnilateralCerebralPalsy. Arch Phys Med RehabilVol 93, April 2012
Keywords : Hemiplegia, upper limb, synkinesis, capacity, performance