Hand Function in Young Children with Cerebral Palsy: Current Practice and Parent-Reported Benefits

Gunvor Lilleholt Klevberg,Sigrid Østensjø,Sonja Elkjær,Ingvild Kjeken,Reidun Birgitta Jahnsen

doi:10.3109/01942638.2016.1158221

Abstract

ABSTRACTAims: To (1) describe characteristics of current interventions to improve hand function in young children with Cerebral Palsy (CP), and explore factors associated with (2) increased likelihood of hand and ADL training and (3) child benefits of training. Methods: A cross-sectional design was used with parent-reported data and data from the Norwegian CP Follow-up Program (CPOP). A total of 102 children (53% of the cohort of newly recruited children in the CPOP, mean age: 30.3 months, SD: 12.1) were included. Hand function was classified according to the Mini-Manual Ability Classification System (Mini-MACS). Data were analyzed with descriptive statistics, cross-tables and direct multiple logistic regressions. Results: The majority of the children performed training of hand skills and ADL. Parents reported high amounts of training, and training was commonly integrated in everyday activities. Both parents (OR = 5.6, p < .011) and OTs (OR = 6.2, p < .002) reported more hand training for children at Mini-MACS levels II-III compared to level I. Parents reported larger child benefits when training was organized as a combination of training sessions and practice within everyday activities (OR = 7.090, p = .011). Conclusions: Parents reported that the children's everyday activities were utilized as opportunities for training, hence describing the intensity of therapy merely by counting minutes or number of sessions seems insufficient.

Highlights

My first encounter with Cerebral Palsy (CP) was when I met “Lisa” during my high-school years
In paper I, descriptions of current practice were based on parent-reported data from the Habilitation Services Questionnaire (HabServ) and data reported by Occupational Therapists (OTs) in the CP follow-up program (CPOP)
Children with unilateral CP were classified at Mini-Manual Ability Classification System (MACS)/MACS levels I-III, and children with bilateral CP were classified at levels I-V

Summary

Introduction

My first encounter with Cerebral Palsy (CP) was when I met “Lisa” during my high-school years With her nearsighted vision, impaired postural control, limited mobility, and limited control of arms and hands, we went to pick strawberries from my parents’ garden. I learned that adaptations of the activity provided her the opportunity to repeat the task successfully and gradually perform it more effectively, as I helped her to identify the berries and prepared so she could grasp them from an easier position. Despite her struggle, I most of all learned about the excitement she expressed by tasting the sweet and juicy berries picked in nature by her own hands. Whereas most typically developing children independently finger-feed and drink from a bottle by one year of age, they may not tie their shoe laces until six to seven years of age, or use a knife and fork effectively until approximately eight years of age.[12]

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Discussion

Conclusion