Abstract:
Objective: To define upper-limb movement deficits in children with hemiplegia using 3-dimensional (3-D) kinematic analysis of functional tasks. Design: Cohort study. Setting: University gait laboratory. Participants: Ten children with hemiplegic cerebral palsy (mean age, 13.3y; range, 10–17y) and 10 control children (mean age, 9.8y; range, 6–12y). Interventions: Not applicable. Main Outcome Measure: 3-D upper-limb movement analysis. Results: 3-D kinematics detected clinically significant between- group differences. Children with hemiplegia were significantly slower than control children in time taken to complete tasks (P .05) and achieved slower movement velocities (P .05). Group differences in range of motion (ROM) occurred in all 3 tasks examined (hand to mouth, hand to head, reach). Children with hemiplegia had significantly less supination (P .03) and shoulder flexion (P .03) and increased compensatory trunk flexion (P .01) compared with control data (hand-to-mouth task). The reach task highlighted restriction of elbow extension in children with hemiplegia (minimum elbow extension: hemiplegia, 24 18o; control, 3 7o). Completing tasks bilaterally did not alter performance of the tasks in children with hemiplegia. Conclusions: 3-D kinematics detected deficits in timing, ROM, and proximal compensatory strategies during upperlimb functional task performance in children with hemiplegia.
