Abstract
BackgroundIn children with spastic diplegia, efficient use of the upper extremity especially the hands play an important role in participation in daily living. Hands can perform heavy activities and also enable to perform extremely gentle, skillful, and precise activities. Inadequate hand strength and fine motor skills may lead to functional limitations. This study was planned to investigate the pinch grip strength and fine manual control in children with spastic diplegic cerebral palsy and to determine if there is a relation between them. Thirty children with diplegic cerebral palsy and 30 normal developed children from both sexes between 5 and 10 years old were included in this study as diplegic and control groups. For all children, pinch grip strength measured by Baseline Mechanical Pinch Gauge and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition used to evaluate fine manual control.ResultsChildren with diplegic cerebral palsy have significant impairment in the pinch grip strength (tip, tripod, and key) and the fine manual control (fine motor precision and integration) compared to their healthy peers of the same age. There was large positive significant correlation (r > 0.5, p < 0.05) between tip and tripod pinch strength, and fine motor precision and medium positive significant correlation (r = 0.47, p < 0.05) between key pinch and fine motor precision in children with spastic diplegia. Also, there was large positive significant correlation between tip pinch and fine motor integration (r = 0.54, p < 0.05). The correlations are small and medium positive between tripod and key pinch strength, and fine motor integration respectively but they are not statistically significant.ConclusionsPinch grip strength and fine manual skills are affected in children with spastic diplegia. Also, there is a significant correlation between the pinch strength and activities require precise control of the hand.
Highlights
In children with spastic diplegia, efficient use of the upper extremity especially the hands play an important role in participation in daily living
Previous study suggested that the Bruininks-Oseretsky Test of Motor Proficiency 2 (BOT-2) is a valid, reproducible tool to evaluate upperlimb fine and gross motor function in children with Cerebral palsy (CP) with a gross motor function classification system (GMFCS) level 1–3 and a manual ability classification system (MACS) level 1–4 so BOT-2 can be used in clinical practice and in research for the evaluation and the follow-up of children with CP [9]
There is a decrease in the BOT-2 scores of children with diplegia compared with their peers at the control group
Summary
In children with spastic diplegia, efficient use of the upper extremity especially the hands play an important role in participation in daily living. This study was planned to investigate the pinch grip strength and fine manual control in children with spastic diplegic cerebral palsy and to determine if there is a relation between them. Cerebral palsy (CP) is a neurodevelopmental disorder that affects muscle tone, posture and motor skills. It is the most common cause of motor disability in infants. Thirty-five percent of children with CP have spastic diplegia; it is considered to be the most common clinical phenotype of CP. Fine motor skills mean using the smaller muscles of the hands to grasp and manipulate objects. These skills are important for all children in everyday activities. Previous study suggested that the BOT-2 is a valid, reproducible tool to evaluate upperlimb fine and gross motor function in children with CP with a gross motor function classification system (GMFCS) level 1–3 and a manual ability classification system (MACS) level 1–4 so BOT-2 can be used in clinical practice and in research for the evaluation and the follow-up of children with CP [9]
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