Objective/Introduction

Children with hemiplegic cerebral palsy (HCP) have upper limb limited motion and decreased hand function in daily activities. The aim of this study was to evaluate the relationship between the severity of the kinematic motion abnormalities and bimanual performance of the impaired upper limb.

Patients and methods

Twenty-three children with HCP (mean age 11.9 ± 2.7 years) were evaluated using the Assisting Hand Assessment (AHA) to score functional activity performance. We used a standardized 3D-analysis protocol to evaluate upper limb movements, containing two reach tasks, three gross motor tasks, and two reach-to-grasp tasks. Summary kinematic indexes were calculated according to Jaspers’ method to evaluate the severity of upper limb movement abnormalities in children with HCP, compared to a database of 28 typically developing children (mean age 11.8 ± 2.2 years).

Results

The results show high correlation between the Global-Arm Profile score (APS), a kinematic index, which summarizes the overall severity of upper limb movement pathology for all tasks, and the AHA score ( r = −0.75). The APS were highly correlated with the AHA during reach-to-grasp tasks ( r = −0.75) and two of the three gross motor tasks ( r = −0.74). Concerning the Global-Arm Variable score, which represents the deviation for a single joint angle, significant correlations were found for wrist flexion ( r = −0.85), elbow flexion ( r = −0.61) and pronation ( r = −0.47).

Discussion/Conclusion

The severity of movement abnormality in children with HCP is strongly correlated with the level of functional activity performance. This correlation is best demonstrated in reach-to-grasp or gross motor tasks. The influence of wrist and elbow movement abnormality confirms the importance of taking into account these distal limitations in therapeutics.