title: Side-to-side growth discrepancies in children with hemiplegic cerebral palsy: association with function, activity and social participation.
abstract: OBJECTIVE
  Evaluate side-to-side discrepancies in children with hemiplegic cerebral palsy (HCP), and investigate associations of these discrepancies with patients' age at initiation of physical therapy, motor and cognitive function, and degree of activities and social participation.
  
  
  METHODS
  We obtained eight side-to-side measurements from 24 HCP children with mean age 49.3±5.2 months.
  
  
  RESULTS
  Early initiation of physical therapy was associated with lower discrepancy in hand length (p=0.037). Lower foot length discrepancy was associated with lower requirement for caregiver assistance in activities related to mobility. Increased side-to-side discrepancy was associated with reduced wrist extension and increased spasticity. Discrepancy played a larger role in children with hemineglect and in those with right involvement.
  
  
  CONCLUSIONS
  Increased discrepancy in HCP children was associated with reduced degree of activity/social participation. These results suggest an association between functional use of the extremities and limb growth.
authors.affiliation: Centro de Neuropediatria, Hospital de Clínicas, Universidade Federal do Paraná, Brazil.
authors.forename: Marise Bueno
authors.initials: MB
authors.lastname: Zonta
authors.affiliation: Universidade Federal de São Paulo, Brazil.
authors.forename: Amâncio
authors.initials: A
authors.lastname: Ramalho-Júnior
authors.affiliation: Centro de Neuropediatria, Hospital de Clínicas, Universidade Federal do Paraná, Brazil.
authors.forename: Marilene
authors.initials: M
authors.lastname: Puppi
authors.affiliation: Departamento de Pediatria, Universidade Federal do Paraná, Brazil.
authors.forename: Isac
authors.initials: I
authors.lastname: Bruck
authors.affiliation: Departamento de Pediatria, Universidade Federal do Paraná, Brazil.
authors.forename: Neiva
authors.initials: N
authors.lastname: Magdalena
authors.affiliation: Centro de Neuropediatria, Hospital de Clínicas, Universidade Federal do Paraná, Brazil.
authors.forename: Sandra Regina B
authors.initials: SR
authors.lastname: Muzzolon
authors.affiliation: Departamento de Clínica Médica, Universidade Federal do Paraná, Brazil.
authors.forename: Arnolfo de
authors.initials: Ad
authors.lastname: Carvalho-Neto
authors.affiliation: Departamento de Pediatria, Universidade Federal do Paraná, Brazil.
authors.forename: Lúcia H Coutinho Dos
authors.initials: LH
authors.lastname: Santos
mesh_terms: D000367:Age Factors; D000886:Anthropometry; D002547:Cerebral Palsy / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006128:Growth / Q000502:physiology*; D006429:Hemiplegia / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength; D026741:Physical Therapy Modalities; D012016:Reference Values; D058992:Social Participation; D013997:Time Factors; D014888:Wechsler Scales