title: Arm and hand function in children with unilateral cerebral palsy: a one-year follow-up study.
abstract: BACKGROUND
  In children with unilateral cerebral palsy (CP), development of arm and hand function is often compromised by the underlying motor and sensory impairments. However, knowledge about the evolution of arm and hand function in this population is limited.
  
  
  OBJECTIVE
  The aims were to map the evolution of scores on upper limb measures over one year in children with unilateral CP and to identify factors that influence time trends.
  
  
  METHODS
  Eighty-one children (43 males, 38 females; mean age 9y11mo (SD 3y3mo) range 5-15 y) were tested at baseline, at 6 and 12 months. According to the International Classification of Functioning, Disability and Health, body function measurements included passive range of motion, muscle tone, manual muscle strength and grip strength. Activity measurements included the Melbourne Assessment, the Jebsen-Taylor test, the Assisting Hand Assessment and the Abilhand-Kids questionnaire. Age, gender, etiology (congenital or acquired lesions) and Manual Ability Classification System (MACS) levels were analyzed as predictive factors, using mixed models.
  
  
  RESULTS
  Scores for grip strength (p = 0.001) and manual dexterity (Jebsen-Taylor test, p < 0.0001) increased significantly over time. MACS level (p = 0.03) and etiology (p = 0.02) had a significant influence on the time evolution of the Jebsen-Taylor scores. Other assessments showed no significant changes.
  
  
  CONCLUSIONS
  Motor impairments, movement quality and hemiplegic hand use in bimanual tasks do not spontaneously improve over one year, except for an age-related change in grip strength. However, an improvement was observed in manual dexterity, suggesting that some children can learn more adaptive movement strategies.
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Heverlee, Belgium. Katrijn.Klingels@faber.kuleuven.be
authors.forename: Katrijn
authors.initials: K
authors.lastname: Klingels
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Wit
authors.forename: Ellen
authors.initials: E
authors.lastname: Jaspers
authors.forename: Ann
authors.initials: A
authors.lastname: Van de Winckel
authors.forename: Geert
authors.initials: G
authors.lastname: Verbeke
authors.forename: Paul
authors.initials: P
authors.lastname: De Cock
authors.forename: Guy
authors.initials: G
authors.lastname: Molenaers
mesh_terms: D000293:Adolescent; D001132:Arm / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular