Immediate effect of a wrist and thumb brace on bimanual activities in children with hemiplegic cerebral palsy.
Summary of "Immediate effect of a wrist and thumb brace on bimanual activities in children with hemiplegic cerebral palsy."
Aim  The aim of this study was to determine the immediate effect of wearing a wrist and thumb brace on the performance of bimanual activities in children with spastic hemiplegic cerebral palsy. Method  In a pre- and post-test cohort study of 25 children (age range 4-11y; mean age 8y 4mo [SD 2y 2mo]; 16 males, 9 females) with spastic hemiplegic cerebral palsy with a Zancolli classification hand score of I, IIA, or IIB (mild and moderate hand dysfunction; children with a Zancolli classification of III - severe hand dysfunction - were excluded from this study), performance of bimanual activities was evaluated with the Assisting Hand Assessment (AHA) on three occasions: one assessment with a static wrist and thumb brace placed on the affected hand and two other assessments without a brace. The differences between AHA scores obtained at the three assessments were evaluated using the repeated measures analysis of variance. Results  Performance of bimanual activities while wearing the brace improved significantly compared to performance without the brace (p<0.001). With the brace, the mean AHA score increased by 3.2 (95% confidence interval 2.1-4.3) from 59.1 to 62.3. The scores of the two assessments without the brace did not differ significantly. Interpretation  In children with spastic hemiplegic cerebral palsy, bracing of the wrist and thumb immediately improves spontaneous use of the affected upper limb in bimanual activities, possibly because bracing permits a more functional hand position.
Affiliation
 Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands  Rehabilitation Center 'De Trappenberg', Huizen, the Netherlands.
Journal Details
This article was published in the following journal.
Name: Developmental medicine and child neurology
ISSN: 1469-8749
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21232053
- DOI: http://dx.doi.org/10.1111/j.1469-8749.2010.03849.x
Medical and Biotech [MESH] Definitions
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Disease involving the ULNAR NERVE from its origin in the BRACHIAL PLEXUS to its termination in the hand. Clinical manifestations may include PARESIS or PARALYSIS of wrist flexion, finger flexion, thumb adduction, finger abduction, and finger adduction. Sensation over the medial palm, fifth finger, and ulnar aspect of the ring finger may also be impaired. Common sites of injury include the AXILLA, cubital tunnel at the ELBOW, and Guyon's canal at the wrist. (From Joynt, Clinical Neurology, 1995, Ch51 pp43-5)
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Pacifiers
Devices that babies can suck on when they are not feeding. The extra sucking can be comforting to the babies and pacify them. Pacifiers usually are used as a substitute for the thumb in babies who suck on their thumb or fingers almost constantly.
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