Abstract
Cerebral palsies (CPs) disturb the voluntary movement control at extremities’ level, entailing various disability degrees. In over 80% of the CP cases there is an upper limb disorder, mainly manifested by the decrease in hand control and the presence of contractures, which, in time, lead to the adoption of abnormal postures which affect the abilities of the CP patients’ hands. The aim of this study was to identify the way the motor deficit at upper limb level – reflected by coordination disturbances and by the condition of the three fingered (tripod) grasp – influences the CP patient’s functional independence. The study demonstrated the existence of significant correlations between Functional Independence Measure (FIM) score, coordination and three fingered grasp. It was proven that the unilateral coordination dysfunctions have a strong negative influence on the coordination of the opposite side and lead to a decrease of the functional independence level. Therefore, the rehabilitation treatment is recommended to be based on a bilateral training, both in order to improve coordination and to obtain a functional level of the three fingered grasp power and of the physiological amplitude at wrist flexion level.
Highlights
The cerebral palsies (CPs) consist in permanent disturbances in the development of movement and posture, occurred further to a non-progressive lesion of the central nervous system during its development
The study was performed during the years 2017-2020, within CNCRNC on a sample consisting in 45 patients aged between 6 and 9 year old, diagnosed with spastic CP, having an intelligence coefficient of IQ ≥ 553 and no significantly modified vision from the standard optotypic, compatible with the rehabilitation treatment within the study
The study analyzed the influence of hand coordination disturbances and of the three-fingered grasp on the functional independence of the CP patient
Summary
The cerebral palsies (CPs) consist in permanent disturbances in the development of movement and posture, occurred further to a non-progressive lesion of the central nervous system during its development. The study excluded the patients with severe psychical or neurological conditions, the ones with unstable or improperly consolidated fractures, osteoporosis, sensorial disturbances which might impede the reporting of any potential pain, spasticity MAS ≥ 3 assesses on the Modified Ashworth Scale[4,5], acute pains which failed to ease further to a conventional pain treatment, articular conditions of the upper limb which, by repeated mobilizations during training, could entail pains and irritations of the affected articulations and the ones whose attendants did not sign the informed consent. The data processing for the analysis of the potential correlations between the collected data followed-up two statistical indicators: statistical significance (p) and Pearson correlation coefficient (r) 6,7
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