Objective

Children with hemiplegic cerebral palsy (HCP) have upper limb deficiencies and movement abnormalities causing difficulties in bimanual activities. The objective of this study was to analyze the abnormalities of movement and the kinematic asymmetry of both upper limbs during a bimanual grasp task in children with HCP.

Patients and methods

Seven hemiplegic children (mean age 13.7 ± 2.4 years) were evaluated through 3D motion analysis during a bimanual and symmetrical grasp task. Different kinematic indexes were calculated to assess the severity of the movement deviation (Arm Profile Score [APS]) and the degree of asymmetry between the two upper limbs (Asym’APS). Kinematic data from hemiplegic children were compared to a 17 typically developing children (TDC) database (mean age 12.1 ± 2.6 years).

Results

The APS score was significantly higher for the impaired upper limb of children with HCP compared to the non-dominant limb of TDC (respectively 21.6° versus 12.8°). The Asym’APS score was significantly higher in the HCP children compared to the TDC (respectively 21.2° and 7.9°). The study of the indexes based on the joint level has made it clearer on which angles deviations and asymmetries were the highest and what compensation strategies were adopted by the unimpaired limb.

Discussion/Conclusion

Hemiplegic children have an angular deviation of the impaired limb more severe and a more important asymmetry between the two upper limbs than typically developing children have during a bimanual and symmetrical grasp task.