Longitudinal development of hand function in children with unilateral cerebral palsy

Dev Med Child Neurol. 2010 Apr;52(4):352-7. doi: 10.1111/j.1469-8749.2009.03364.x. Epub 2009 Jul 3.


Aim: The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years.

Method: A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y 8mo [SD 1y 1mo]). Children were assessed with the Assisting Hand Assessment (AHA) 3 to 11 times per child over a mean period of 4 years 6 months. Two models were used for grouping children: by AHA score at 18 months and by Manual Ability Classification System (MACS) levels. Estimated average motor development curves were fitted with a nonlinear mixed-effects model.

Results: Children with a high AHA score (high ability level) at 18 months reached a significantly higher ability level and at a higher progression rate than children with a low 18-month AHA score. Limits of development differed between the three MACS levels.

Interpretation: Results indicate that the AHA score at 18 months can be used to discuss future development of affected hand use in bimanual tasks in children with unilateral CP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Cerebral Palsy / pathology*
  • Cerebral Palsy / physiopathology
  • Child
  • Child Development / physiology
  • Child, Preschool
  • Disability Evaluation
  • Disease Progression
  • Female
  • Functional Laterality / physiology*
  • Hand / physiopathology*
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Motor Skills / physiology*
  • Nonlinear Dynamics
  • Predictive Value of Tests
  • Psychometrics / methods
  • Severity of Illness Index
  • Task Performance and Analysis
  • Time Factors