Hand function development of children with hemiplegic cerebral palsy: A scoping review

Author(s):  
James V. McCall ◽  
Miranda C. Ludovice ◽  
Catherine Elliott ◽  
Derek G. Kamper

PURPOSE: Hemiplegic cerebral palsy (hCP) typically impacts sensorimotor control of the hand, but comprehensive assessments of the hands of children with hCP are relatively rare. This scoping review summarizes the development of hand function for children with hCP. METHODS: This scoping review focused on the development of hand function in children with hCP. Electronic databases (PubMed, PEDro, Web of Science, CINAHL, and SpringerLink) were searched to identify studies assessing hand function in children with hCP. The search was performed using keywords (e.g., “hemiplegia”). An iterative approach verified by two authors was used to select the studies. Articles which reported quantitative data for children with hCP on any items of a specified set of hand evaluations were included. Measures were sorted into three categories: quantitative neuromechanics, clinical assessments, and clinical functional evaluations. RESULTS: Initial searches returned 1536 articles, 131 of which were included in the final review. Trends between assessment scores and age were examined for both hands. CONCLUSION: While several studies have evaluated hand function in children with hCP, the majority relied on clinical scales, assessments, or qualitative descriptions. Further assessments of kinematics, kinetics, and muscle activation patterns are needed to identify the underlying impairment mechanisms that should be targeted for treatment.

2010 ◽  
Vol 90 (7) ◽  
pp. 986-997 ◽  
Author(s):  
Laura A. Prosser ◽  
Samuel C.K. Lee ◽  
Ann F. VanSant ◽  
Mary F. Barbe ◽  
Richard T. Lauer

Background Poor control of postural muscles is a primary impairment in people with cerebral palsy (CP). Objective The purpose of this study was to investigate differences in the timing characteristics of trunk and hip muscle activity during walking in young children with CP compared with children with typical development (TD). Methods Thirty-one children (16 with TD, 15 with CP) with an average of 28.5 months of walking experience participated in this observational study. Electromyographic data were collected from 16 trunk and hip muscles as participants walked at a self-selected pace. A custom-written computer program determined onset and offset of activity. Activation and coactivation data were analyzed for group differences. Results The children with CP had greater total activation and coactivation for all muscles except the external oblique muscle and differences in the timing of activation for all muscles compared with the TD group. The implications of the observed muscle activation patterns are discussed in reference to existing postural control literature. Limitations The potential influence of recording activity from adjacent deep trunk muscles is discussed, as well as the influence of the use of an assistive device by some children with CP. Conclusions Young children with CP demonstrate excessive, nonreciprocal trunk and hip muscle activation during walking compared with children with TD. Future studies should investigate the efficacy of treatments to reduce excessive muscle activity and improve coordination of postural muscles in CP.


Author(s):  
Roland van den Tillaar ◽  
Eirik Lindset Kristiansen ◽  
Stian Larsen

This study compared the kinetics, barbell, and joint kinematics and muscle activation patterns between a one-repetition maximum (1-RM) Smith machine squat and isometric squats performed at 10 different heights from the lowest barbell height. The aim was to investigate if force output is lowest in the sticking region, indicating that this is a poor biomechanical region. Twelve resistance trained males (age: 22 ± 5 years, mass: 83.5 ± 39 kg, height: 1.81 ± 0.20 m) were tested. A repeated two-way analysis of variance showed that Force output decreased in the sticking region for the 1-RM trial, while for the isometric trials, force output was lowest between 0–15 cm from the lowest barbell height, data that support the sticking region is a poor biomechanical region. Almost all muscles showed higher activity at 1-RM compared with isometric attempts (p < 0.05). The quadriceps activity decreased, and the gluteus maximus and shank muscle activity increased with increasing height (p ≤ 0.024). Moreover, the vastus muscles decreased only for the 1-RM trial while remaining stable at the same positions in the isometric trials (p = 0.04), indicating that potentiation occurs. Our findings suggest that a co-contraction between the hip and knee extensors, together with potentiation from the vastus muscles during ascent, creates a poor biomechanical region for force output, and thereby the sticking region among recreationally resistance trained males during 1-RM Smith machine squats.


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