DIFFERENT TYPES OF ASYMMETRIC HAND INVOLVEMENTS AND FUNCTIONAL INDEPENDENCE IN CHILDREN WITH CEREBRAL PALSY: A RETROSPECTIVE STUDY

Purpose: The aim of this study was to investigate the effect of different types of functional asymmetric hand involvements on upper extremity activity performance and functional independence in children with cerebral palsy (CP).

Methods: In this retrospective study, 49 children with CP aged 3-12 years with different types of asymmetric functional hand involvements were analyzed. Asymmetric hand functions of the children were classified according to Bimanuel Fine Motor Function (BFMF-2.0). Upper extremity activity performance and functional independence status were evaluated with ABILHAND-Kids and Functional Independence Measure for Children (WeeFIM). The Kruskal-Wallis test was used for comparison between BFMF-2.0 levels.

Results: Children [7.18 ± 4.52 y (3-12 y), 26 girls (53.1%)] were divided into four groups as BFMF-2.0 level IIa (n=16), level IIIa (n=12), level IIIb (n=11) and IVb (n=10) according to functional asymmetric hand involvements. There was a significant difference between the groups (p<0.001). In pairwise comparisons, the difference between levels IVb and IIa was significant in WeeFIM and ABILHAND-Kids scores (p<0.008).

Discussion: In-hand manipulation skills are critical for upper extremity performance and functional independence of daily living activities in children with CP. In-hand manipulation of one hand may increase the functional independence of the child regardless of the other hand’s involvement level.