Development Of Hand Function Research Articles

Development of hand function during the first year of life in children with unilateral cerebral palsy.

To identify developmental trajectories of hand function in infants aged 3 months to 12 months with unilateral cerebral palsy (CP). Infants at high risk of unilateral CP were recruited from 3 months of age from follow-up programmes and clinics in Sweden, the Netherlands, Italy, and Australia. Measurements on the Hand Assessment for Infants (HAI) were completed until 12 months of age. Group-based trajectory modelling was used to identify subgroups of infants with similar trajectories of development. Multinomial logistic regression determined associations between demographic variables and trajectory membership. Ninety-seven infants (52 males, 45 females; median gestational age 38wks [interquartile range 30-40wks]) were included. Infants were assessed between two and seven times (mean 4, SD 1.2) with a total of 387 observations. A three-group trajectory model identified a 'low-functioning group' (n=45: 46%), 'moderate-functioning group' (n=30: 31%), and 'high-functioning group' (n=22: 23%). Mean posterior probabilities (0.91-0.96) and odds of correct classification (26.3-33.2) indicated good model fit. Type of brain lesion, sex, side of hemiplegia, country, gestational age, and access to intensive intervention were not associated with group membership. Three trajectories of hand function development for infants with unilateral CP were identified and indicate some greater distinctions between groups with increasing age. The HAI is a valuable measure, capturing development of hand function of infants with unilateral CP over time. Three distinct developmental trajectories of hand function in infants with unilateral cerebral palsy were identified. A low-functioning group made little progress in development of hand function in the first year of life. The degree of impairment on the impaired hand at 6 months of age is highly associated with trajectory membership. Infants with all types of brain lesion were represented across each trajectory group.

Development of hand function during the first year of life in children with unilateral cerebral palsy

Development of hand function during the first year of life in children with unilateral cerebral palsy

Relation between hand function and gross motor function in full term infants aged 4 to 8 months.

Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

3PS3.1 Development of hand function and predictors for development in unilateral cebral palsy. Aspects of hand function, usefulness, development and intervention

3PS3.1 Development of hand function and predictors for development in unilateral cebral palsy. Aspects of hand function, usefulness, development and intervention

Development of Hand Function and Precision Grip Control in Individuals With Cerebral Palsy: A 13-Year Follow-up Study

Although children with cerebral palsy display large developmental differences in hand function from that of typically developing children by the age of 6 to 10 years, little is known about the developmental processes underlying hand function during subsequent development. In this study we investigated the development of manual dexterity in a timed motor task, the timing and amplitude of fingertip-force application during a precision grasping task, and the relationship between changes in these measures. We applied highly quantitative analytical approaches to determine if the fingertip-force application pattern and trial-to-trial variation of fingertip-force application change during development. Twelve subjects with cerebral palsy (aged 6-8 years) participated in the first data-collection session conducted between 1989 and 1990. Ten of these subjects (5 with hemiplegia and 5 with diplegia, aged 19-21 years) returned between 2002 and 2003. Manual dexterity was measured by using timed tasks of the Jebsen-Taylor test of hand function. Subjects also lifted an object instrumented with force transducers while we measured the temporal coordination of fingertip coordination and the path ratio between the grip and vertical load-force trajectory (straightness). We used generalized procrustes analysis to determine if there were changes in shape of the force trajectory and intertrial variability. The Jebsen-Taylor test times decreased 45% from the first to the second data session. The overall time to complete the grip-lift task decreased 22%, mainly because of a faster transition from grasp to lift. The grip-force/load-force path ratios decreased from 1.7 to 1.35 (1 = straight line). Generalized procrustes analysis indicated a change in the shape and a decrease in variability in shape of the force-ratio path. Our results demonstrate that the efficiency in grasping had developed during a 13-year period for this small group of participants with cerebral palsy, which suggests that improvement in hand function occurs over a longer time frame than commonly would be expected.

Impact of Hand Burn Severity on Preschooler Health Related Quality of Life

The preschool years are a critical time in the development of hand function. At this juncture children develop hand preference and learn complex bimanual tasks. These skills lay the groundwork for independence with activities of daily living (ADLs), and for proficiency in both play and work. Hand burns are a leading cause of hand injury in children, yet little is known about the long-term consequences of hand burn injury on their health-related quality of life (QoL). The purpose of this study is to analyze the effects of hand burn severity on QoL in children 0–4 years of age. A validated burn outcomes questionnaire assessing QoL in children aged 0–4 years was administered at the first clinic appointment post-discharge and at 3, 6, 12, 18, and 24 months thereafter to patients treated at two pediatric burn centers. Extent of burn injury was evaluated by burn size and depth, location, number of...

Development of hand function among children with cerebral palsy: growth curve analysis for ages 16 to 70 months, Erratum

Development of hand function among children with cerebral palsy: growth curve analysis for ages 16 to 70 months, Erratum

Development of hand function among children with cerebral palsy: growth curve analysis for ages 16 to 70 months

This study documents the development of hand and upper‐extremity function in young children who have cerebral palsy (CP) with upper‐extremity involvement using longitudinal data. Assessments of hand function and the quality of upper‐extremity movement were conducted on 29 males and 22 females (mean age 36.2 months, SD 10.6; age range 16 to 60 months at baseline) and on four other occasions over 10 months. Linear mixed effects modeling was used to estimate average developmental curves and the degree of individual differences in the patterns of development which were conditional on the body‐site distribution of CP and severity of impairments. Results indicate that hand function in this clinical population develops differently from overall upper‐extremity skills with declines in function in upper‐extremity skills being more common and pronounced among older children. However, there is substantial interindividual variation. Distribution of CP and severity of impairments were significant predictors of development. Results are discussed in terms of their clinical implications.

Development of hand function among children with cerebral palsy: growth curve analysis for ages 16 to 70 months

This study documents the development of hand and upper-extremity function in young children who have cerebral palsy (CP) with upper-extremity involvement using longitudinal data. Assessments of hand function and the quality of upper-extremity movement were conducted on 29 males and 22 females (mean age 36.2 months, SD 10.6; age range 16 to 60 months at baseline) and on four other occasions over 10 months. Linear mixed effects modeling was used to estimate average developmental curves and the degree of individual differences in the patterns of development which were conditional on the body-site distribution of CP and severity of impairments. Results indicate that hand function in this clinical population develops differently from overall upper-extremity skills with declines in function in upper-extremity skills being more common and pronounced among older children. However, there is substantial interindividual variation. Distribution of CP and severity of impairments were significant predictors of development. Results are discussed in terms of their clinical implications.

Characteristics of motor disturbances of the Rett syndrome

The stereotyped movement of hands, one of the core symptoms of the Rett syndrome (RS), was analyzed to study the pathophysiology. The development of hand function was delayed after mid-infancy and handedness was undetermined in most cases. Before the onset of the pathognomonic stereotypy, patients showed excessive or abnormal behaviors of hands and mouth, such as patting or licking hands, etc. The useful hand function was lost just before or after the onset of stereotypy. The characteristic "hand wringing" movement at midline became apparent from 8 months to 3 years of age. The synchronous hand movement without reaching the midline and leg movement at midline were also seen in some patients. Based on the analysis of these symptoms, it is suggested that the stereotyped movements of RS are manifestation of fragments of normal motor behaviors at immature levels appearing excessively and repetitively with the abnormal basic posture. The pathophysiological mechanism of these characteristics is thought to be due to the hypofunctional state of the monoaminergic system from early ontogeny, which is in accordance with our previous hypothesis that RS is a developmental disorder of the monoaminergic system. The roles of the cortical involvement and sensory system are also discussed.