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Prevalence and pattern of upper limb involvement in cerebral palsy

PURPOSE: The aim of this study was to determine the prevalence and pattern of upper limb involvement in children with cerebral palsy (CP), how this relates to function and how well these problems are recognised and treated. METHODS: One hundred consecutive patients with CP attending non-hand-related...

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Autores principales: Makki, Daoud, Duodu, J., Nixon, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142879/
https://www.ncbi.nlm.nih.gov/pubmed/24824566
http://dx.doi.org/10.1007/s11832-014-0593-0
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author Makki, Daoud
Duodu, J.
Nixon, Matthew
author_facet Makki, Daoud
Duodu, J.
Nixon, Matthew
author_sort Makki, Daoud
collection PubMed
description PURPOSE: The aim of this study was to determine the prevalence and pattern of upper limb involvement in children with cerebral palsy (CP), how this relates to function and how well these problems are recognised and treated. METHODS: One hundred consecutive patients with CP attending non-hand-related clinics were assessed. Function was assessed according to the Gross Motor Functional Classification System (GMFCS), the Manual Ability Classification System (MACS) and the ABILHAND-Kids system, and correlated to age and pattern of upper limb involvement. Patients were examined for contractures in the shoulder, elbow, wrist and hand. Concerns about the appearance of the hand were also assessed in older children. RESULTS: Overall, 83 % of patients had upper limb involvement, 36 % had a demonstrable contracture and 69 % had reduced hand control. The most common contracture patterns were the thumb in palm with clasp hand, shoulder adduction with internal rotation and wrist flexion with pronation. The thumb in palm with clasp hand pattern was associated with the greatest functional disability, followed by wrist flexion with pronation. Single contractures such as elbow flexion caused significant disability, whereas swan-neck contractures were, by far, less debilitating. Children aged 12 years and older had more concerns about the appearance of their hand. The ABILHAND score was strongly correlated to both the GMFCS and the MACS score. CONCLUSION: Different patterns of upper limb involvement exist in CP and some have a significant impact on function and cause cosmetic concerns that should not be underestimated, particularly in older children.
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spelling pubmed-41428792014-08-29 Prevalence and pattern of upper limb involvement in cerebral palsy Makki, Daoud Duodu, J. Nixon, Matthew J Child Orthop Original Clinical Article PURPOSE: The aim of this study was to determine the prevalence and pattern of upper limb involvement in children with cerebral palsy (CP), how this relates to function and how well these problems are recognised and treated. METHODS: One hundred consecutive patients with CP attending non-hand-related clinics were assessed. Function was assessed according to the Gross Motor Functional Classification System (GMFCS), the Manual Ability Classification System (MACS) and the ABILHAND-Kids system, and correlated to age and pattern of upper limb involvement. Patients were examined for contractures in the shoulder, elbow, wrist and hand. Concerns about the appearance of the hand were also assessed in older children. RESULTS: Overall, 83 % of patients had upper limb involvement, 36 % had a demonstrable contracture and 69 % had reduced hand control. The most common contracture patterns were the thumb in palm with clasp hand, shoulder adduction with internal rotation and wrist flexion with pronation. The thumb in palm with clasp hand pattern was associated with the greatest functional disability, followed by wrist flexion with pronation. Single contractures such as elbow flexion caused significant disability, whereas swan-neck contractures were, by far, less debilitating. Children aged 12 years and older had more concerns about the appearance of their hand. The ABILHAND score was strongly correlated to both the GMFCS and the MACS score. CONCLUSION: Different patterns of upper limb involvement exist in CP and some have a significant impact on function and cause cosmetic concerns that should not be underestimated, particularly in older children. Springer Berlin Heidelberg 2014-05-14 2014-05 /pmc/articles/PMC4142879/ /pubmed/24824566 http://dx.doi.org/10.1007/s11832-014-0593-0 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Clinical Article
Makki, Daoud
Duodu, J.
Nixon, Matthew
Prevalence and pattern of upper limb involvement in cerebral palsy
title Prevalence and pattern of upper limb involvement in cerebral palsy
title_full Prevalence and pattern of upper limb involvement in cerebral palsy
title_fullStr Prevalence and pattern of upper limb involvement in cerebral palsy
title_full_unstemmed Prevalence and pattern of upper limb involvement in cerebral palsy
title_short Prevalence and pattern of upper limb involvement in cerebral palsy
title_sort prevalence and pattern of upper limb involvement in cerebral palsy
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142879/
https://www.ncbi.nlm.nih.gov/pubmed/24824566
http://dx.doi.org/10.1007/s11832-014-0593-0
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