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Arch Phys Med Rehabil. 2012 Apr;93(4):696-702. doi: 10.1016/j.apmr.2011.10.025. Epub 2012 Feb 22.

Impact of tactile dysfunction on upper-limb motor performance in children with unilateral cerebral palsy.

Author information

  • 1Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. mauld@uq.edu.au

Abstract

OBJECTIVE:

To determine the relationship between tactile function and upper-limb function in children with unilateral cerebral palsy (CP).

DESIGN:

Cross-sectional study.

SETTING:

Assessments were performed in community or hospital venues or in participants' homes.

PARTICIPANTS:

Recruitment information was sent to 253 possible participants with unilateral CP (aged 8-18 y), and N=52 participated (median age [interquartile range], 12 y [9-14 y]; Gross Motor Functional Classification System level I=34; II=18; Manual Abilities Classification Scale level I=36; II=16).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

Tactile assessment included 1 test of registration, 5 tests for spatial perception, and 1 test for texture perception. Upper-limb motor function was assessed using 2 unimanual tests, the Melbourne Unilateral Upper Limb Assessment (MUUL) and Jebsen-Taylor Test of Hand Function (JTTHF), and 1 bimanual test, the Assisting Hand Assessment (AHA).

RESULTS:

Tactile registration and all tests of spatial perception were moderately related to the MUUL, JTTHF, and AHA (P<.001). Texture perception was not related to upper-limb motor function. Regression analysis showed that single point localization, a unilateral tactile spatial perception test, contributed most strongly to unimanual capacity (29% explained variance in MUUL and 26% explained variance in JTTHF), whereas double simultaneous, a bilateral tactile spatial perception test, contributed most strongly to bimanual performance (33% for the AHA).

CONCLUSIONS:

Spatial tactile deficits account for approximately 30% of the variance in upper-limb motor function in children with unilateral CP. This emphasizes the need for routine tactile assessment and targeted treatment of tactile spatial deficits in this population.

Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

PMID:
22360974
[PubMed - indexed for MEDLINE]
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