Relation between clinical measures and fine manipulative control in children with hemiplegic cerebral palsy

The present investigation examines the relation between various clinical me asures and the performance of a functional precision grip-lift task. Fiftee n children with hemiplegic cerebral palsy (CP), aged 8 to 14 years, and 15 age-matched control children grasped and lifted an object whose surface tex ture was varied while their fingertip forces were recorded. The force coord ination was compared with tactile sensibility, grip strength, manual dexter ity, and spasticity using correlational and regression analyses. The findin gs highlight the importance of tactile sensibility in this task. However, t he manner in which sensibility was related varied for the sensory adaptatio n of fingertip forces, the anticipatory scaling of the force increase, and the smooth transitions between the temporal phases comprising the grip-lift task. The findings also indicate that spasticity affects some measures of the task, but not others, suggesting that the relation between spasticity a nd motor performance may not be absolute. The results further suggest that the impairments in grasping in children with hemiplegic CP are largely but not exclusively due to disturbed sensory mechanisms which may have direct i mplications for therapeutic intervention.