Hand Function in a Population-Based Sample of Young Children with Unilateral or Bilateral Cerebral Palsy.
OBJECTIVE
To describe aspects of hand function in a population-based sample of young children with clinical signs of unilateral or bilateral cerebral palsy (CP).


METHODS
A cross-sectional study with data from national CP registers in Norway. Manual ability was classified with the Manual Ability Classification System (MACS) or Mini-MACS. Hand use in bimanual activities was measured with the Assisting Hand Assessment (AHA) for unilateral CP or the newly developed Both Hands Assessment (BoHA) for bilateral CP.


RESULTS
From 202 children, 128 (57 females) were included (Mini-MACS/MACS levels I-V, mean age 30.4 months; SD = 12.1). Manual abilities were distributed across levels I-III in unilateral CP and levels I-V in bilateral CP. Variations in AHA and BoHA units were large. One-way ANOVA revealed associations between higher AHA or BoHA units and Mini-MACS/MACS levels of higher ability (p < 0.01) and higher age (p < 0.04).


CONCLUSIONS
Compared with young children with unilateral CP, children with bilateral CP showed greater variation in Mini-MACS/MACS levels, and both sub-groups showed large variations in AHA or BoHA units. The classifications and assessments used in this study are useful to differentiate young children's ability levels. Such information is important to tailor upper limb interventions to the specific needs of children with CP.
a Research Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society , University of Oslo , Oslo , Norway.
Gunvor L
http://orcid.org/0000-0002-2005-2102
GL
Klevberg
b Faculty of Health Sciences , Oslo and Akershus University College of Applied Sciences , Oslo , Norway.
Sigrid
http://orcid.org/0000-0002-7418-2973
S
Østensjø
c Neuropediatric Unit, Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.
Lena
L
Krumlinde-Sundholm
d The Cerebral Palsy Follow-Up Program (CPOP), Department of Neurosciences for Children , Oslo University Hospital , Oslo , Norway.
Sonja
S
Elkjær
d The Cerebral Palsy Follow-Up Program (CPOP), Department of Neurosciences for Children , Oslo University Hospital , Oslo , Norway.
Reidun B
RB
Jahnsen
D001930:Brain Injuries / Q000175:diagnosis* / Q000209:etiology; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009664:Norway; D012042:Registries; D012720:Severity of Illness Index
Assisting hand assessment; bimanual performance; both hands assessment; cerebral palsy; child; hand function