Hand function deficits in individuals with spastic diplegia

Date
2011
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University of Delaware
Abstract
Cerebral Palsy (CP) is a neurological condition caused by a non-progressive pre/perinatal lesion to brain that impedes one's motor behavior. Two positively correlated (Himmelmann, et al, 2006), commonly used methods to describe motor behavior in CP are the Gross Motor Function Classification System (GMFCS) (Palisano, et al, 1997) and the Bimanual Fine Motor Function (BFMF) scale (Himmelmann, et al, 2006). This raises questions on the origins of this poor performance in hand function as it pertains to individuals with the type of CP, spastic diplegia. It is a type of CP where spasticity does not significantly influence the hands. Prior to this study, most of the study on hand function in individuals with CP focused on the subtype of CP, spastic hemiplegia (SH) (Hadders-Algra, et al, 1999; Hirschfeld, 2007; Steenbergen & Gordon, 2006). These studies suggest that dysfunction may be global in CP. This idea may explain possible hand function deficits in individuals with the SD. Three tests were performed to investigate how SD affects hand function. There were 6 people in the SD group and 6 age/gender-matched individuals in a typically developing (TD) group with no neurological conditions. We used the Jebsen Taylor test to examine functional motor deficits in every day tasks. The SD group significantly differed from the TD group. The other two tasks, a task in the end task comfort (ETC) paradigm and a task measuring the coordination of grip forces were used to determine where this deficit might originate. There were no group differences in performance of the ETC test. This suggested that anticipatory motor planning may not cause the deficits seen in the Jebsen Taylor test. However, repeated examination may yield more polarizing results. It still may be possible that motor planning deficits exist but they were unable to be described in this study. Differences were found in variables indicating poor task performance and poor ability to modulate grip force relative to load force. There was excessive gripping and higher variability in hand force production. This may explain the deficit seen in the Jebsen Taylor test. This suggested that any deficits in hand function in people with SD might result from an inability to properly execute force sequencing.
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