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Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Leaning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Health Sciences.ORCID iD: 0000-0001-5418-3154
2023 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 65, no 3, p. 376-384Article in journal (Refereed) Published
Abstract [en]

AIM: To describe the development of the use of the affected hand in bimanual tasks in children with unilateral cerebral palsy (CP) from 18 months to 18 years. Specifically, whether early development can be confirmed in a larger cohort and how development progresses during adolescence.

METHOD: In total, 171 participants (95 males, 76 females; mean age 3 years 1 month [SD 3 years 8 months], range 18 months-16 years at inclusion) were classified in Manual Ability Classification System (MACS) levels I (n = 41), II (n = 91), and III (n = 39). Children were assessed repeatedly (median 7, range 2-16 times) with the Assisting Hand Assessment: in total 1197 assessments. Developmental trajectories were estimated using a nonlinear mixed effects model. To further analyse the adolescent period, a linear mixed model was applied.

RESULTS: The developmental trajectories were different between participants in MACS levels (MACS I-II, II-III) in both rate (0.019, 95% confidence interval [CI] 0.006-0.031, p = 0.034; 0.025, 95% CI 0.015-0.037, p < 0.001) and limit (19.9, 95% CI 16.6-23.3, p = 0.001; 7.2, 95% CI 3.3-11.2, p < 0.003). The individual variations were large within each level. The developmental trajectories were stable over time for all MACS levels between 7 and 18 years (p > 0.05).

INTERPRETATION: Children and adolescents with unilateral CP have considerable development at an early age and a stable ability to use their affected hand in bimanual activities from 7 to 18 years in all MACS levels.

Place, publisher, year, edition, pages
Mac Keith Press, 2023. Vol. 65, no 3, p. 376-384
National Category
Psychology (excluding Applied Psychology) Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-100626DOI: 10.1111/dmcn.15370ISI: 000831136400001PubMedID: 35899928Scopus ID: 2-s2.0-85135063446OAI: oai:DiVA.org:oru-100626DiVA, id: diva2:1688670
Note

Plain Language Summary:

Developmental Medicine & Child Neurology. Vol. 65, Issue 10, e101-e102

DOI: 10.1111/dmcn.15735

WOS: 001051762500001

PubMed ID: 37587730

Available from: 2022-08-19 Created: 2022-08-19 Last updated: 2023-12-08Bibliographically approved

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Holmefur, Marie

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