title: Longitudinal development of hand function in children with unilateral spastic cerebral palsy aged 18 months to 12 years.
abstract: The aim of the study was to describe the development of hand function, particularly the use of the affected hand in bimanual tasks, among children with unilateral cerebral palsy aged 18 months to 12 years.
  
  
  
  A convenience sample of 96 children (53 males, 43 females) was assessed with the Assisting Hand Assessment (AHA) at regular intervals from the ages of 18 months to 12 years. The children ranged from 17 to 127 months (median age 24mo) at recruitment. Subgroups were created to identify differences in development using the child's AHA at 18 months and the Manual Ability Classification System (MACS). A nonlinear mixed effects model was used to analyze data according to a 'stable limit' development model.
  
  
  
  The results were based on 702 AHA sessions. The children showed a rapid development at a young age and reached 90% of their stable limit between 30 months and 8 years. The subgroups, based on the 18-month AHA and the MACS levels respectively, had distinctly different patterns of development.
  
  
  
  The AHA at 18 months may be used to make a crude prediction of future development.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Nordstrand
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Eliasson
authors.affiliation: School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Holmefur
mesh_terms: D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009128:Muscle Spasticity / Q000503:physiopathology; D012720:Severity of Illness Index