Mirror movements in unilateral spastic cerebral palsy: Specific negative impact on bimanual activities of daily living

Aim: Mirror movements are involuntary movements of the other hand during voluntary unimanual movements. Some, but not all children with unilateral spastic cerebral palsy (USCP) show this phenomenon. In this observational study, we investigated whether these mirror movements have a specific negative impact on bimanual activities of daily living.

Methods: Eighteen children (six girls; age range, 6-16 years; mean age, 12 years 1 month; SD, 3 years 3 month) with USCP, nine with and nine without mirror movements, underwent the Jebsen Taylor Hand Function Test (unimanual capacity) and the Assisting Hand Assessment (bimanual performance). In addition, we measured the time the participants needed for the completion of five activities we had identified as particularly difficult for children with mirror movements.

Results: Multivariate analysis demonstrated that mirror movements indeed have a specific negative impact on bimanual performance (Assisting Hand Assessment) and on the time needed for the completion of these five particularly difficult activities. This effect was independent from unimanual capacity.

Conclusion: Functional therapies in children with USCP and mirror movements should address this phenomenon.