title: The Effect of Treatment on Stereognosis in Children With Hemiplegic Cerebral Palsy.
abstract: OBJECTIVE
  To determine if rehabilitation alone or combined with surgery or botulinum toxin injection improved stereognosis in children with hemiplegic cerebral palsy.
  
  
  METHODS
  Inclusion criteria were children with spastic hemiplegic cerebral palsy who had stereognosis testing 2 separate times with documentation of intervening treatment. Sixty-three children were included, 30 girls and 33 boys at an average age of 9.1 years (range, 4.4-16.0 years). Twelve standardized objects were used for manual identification. Baseline and postintervention stereognosis results were recorded for the hemiplegic and the dominant limb of each patient. The patients were separated into 3 groups based on intervening treatment: surgery with rehabilitation (27 patients), botulinum toxin injection with rehabilitation (19 subjects), and rehabilitation alone (7 subjects). Results were also analyzed by patient age group.
  
  
  RESULTS
  Baseline testing of the hemiplegic limb revealed that 27 patients (43%) exhibited severe stereognosis impairment (0-4 objects identified correctly), 18 (28%) were moderately impaired (5-8 objects), 13 (21%) were mildly impaired (9-11 objects), and 5 (8%) had intact stereognosis (12 objects). There was no statistically significant difference in change in stereognosis scores postintervention among the 3 different treatment groups or between patients who had surgery and those who did not have surgery. There was no statistically significant difference in stereognosis function or postintervention change based on patient age at time of testing.
  
  
  CONCLUSIONS
  In this study, 92% of children with spastic hemiplegic cerebral palsy had stereognosis impairment with a wide spectrum of severity. After operative or nonoperative treatment interventions, stereognosis as a secondary outcome measure was not changed.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: Erica
authors.initials: E
authors.lastname: Petersen
authors.affiliation: Shriners Hospital for Children, Minneapolis, MN.
authors.forename: Wendy
authors.initials: W
authors.lastname: Tomhave
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: Julie
authors.initials: J
authors.lastname: Agel
authors.affiliation: Shriners Hospital for Children, UC Davis Health System, Sacramento, CA.
authors.forename: Anita
authors.initials: A
authors.lastname: Bagley
authors.affiliation: Shriners Hospital for Children, UC Davis Health System, Sacramento, CA.
authors.forename: Michelle
authors.initials: M
authors.lastname: James
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN; Shriners Hospital for Children, Minneapolis, MN. Electronic address: vanhe003@umn.edu.
authors.forename: Ann
authors.initials: A
authors.lastname: Van Heest
mesh_terms: D000293:Adolescent; D001905:Botulinum Toxins / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology / Q000628:therapy; D009483:Neuropsychological Tests; D009498:Neurotoxins / Q000627:therapeutic use; D012720:Severity of Illness Index; D013236:Stereognosis / Q000502:physiology*
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins
keywords: Cerebral palsy; hand; pediatric; stereognosis