title: Mirror movements in unilateral spastic cerebral palsy: Specific negative impact on bimanual activities of daily living.
abstract: OBJECTIVE
  Mirror movements are involuntary movements of the other hand during voluntary unimanual movements. Some, but not all children with unilateral spastic cerebral palsy (USCP) show this phenomenon. In this observational study, we investigated whether these mirror movements have a specific negative impact on bimanual activities of daily living.
  
  
  METHODS
  Eighteen children (six girls; age range, 6-16 years; mean age, 12 years 1 month; SD, 3 years 3 month) with USCP, nine with and nine without mirror movements, underwent the Jebsen Taylor Hand Function Test (unimanual capacity) and the Assisting Hand Assessment (bimanual performance). In addition, we measured the time the participants needed for the completion of five activities we had identified as particularly difficult for children with mirror movements.
  
  
  RESULTS
  Multivariate analysis demonstrated that mirror movements indeed have a specific negative impact on bimanual performance (Assisting Hand Assessment) and on the time needed for the completion of these five particularly difficult activities. This effect was independent from unimanual capacity.
  
  
  CONCLUSIONS
  Functional therapies in children with USCP and mirror movements should address this phenomenon.
authors.affiliation: Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Germany; Dept. Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Adler
authors.affiliation: Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Germany; Dr. von Hauners Children's Hospital, Ludwig-Maximilians-University Munich, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Berweck
authors.affiliation: Dept. Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany.
authors.forename: Karen
authors.initials: K
authors.lastname: Lidzba
authors.affiliation: Center for Child Neurology, Sana Klinik Düsseldorf, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Becher
authors.affiliation: Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Germany; Dept. Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany. Electronic address: mstaudt@schoen-kliniken.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Staudt
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D009069:Movement Disorders / Q000503:physiopathology*
keywords: ADL; Bimanual; Congenital hemiparesis; Mirror movements; Occupational therapy