Krekel Nicole M A, Smeulders Mark J C, Klaij Frida, Margry Ruud, Kreulen Mick
Academisch Medisch Centrum, afd. Plastische -, reconstructieve- en handchirurgie, Amsterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1527.
To examine the relationship between impaired manual dexterity and perceived competence in children with cerebral palsy and the effect of surgical intervention, with the question whether the perceived competence is applicable as an outcome measure for surgical reconstruction of hand function.
The Dutch version of the Michigan Hand Outcomes Questionnaire (MHQ-DLV) for perceived manual dexterity and the Dutch version of the Harter Scales for perceived competence were used in a sample of 25 children and adolescents with hemiplegic cerebral palsy of the spastic type. 10 patients underwent surgical treatment to improve hand function. In this 'surgical group' both questionnaires were repeated at least one year postoperatively.
Perceived manual dexterity was low (mean MHQ-DLV-score: 63.2; SD: 18.9), as were the scores of perceived overall competence (2.92; SD: 0.84), social competences (2.66; SD: 0.92) and athletic competences (2.29; SD: 0.79). There was no correlation between the degree of perceived impairment in manual dexterity and the perceived competence (r = -0.16; p = 0.43). After surgical reconstruction manual dexterity improved (mean increase in score: 24; SD: 10.4; p < 0.01), but perceived competence did not improve (p = 0.39).
Children with cerebral palsy and impaired manual dexterity did have a lower perceived competence than children without this disorder. The extent to which manual dexterity was impaired did not correlate with the extent to which perceived competence was lowered. Surgical intervention substantially improved perceived manual dexterity, but perceived competence did not improve. Perceived competence does not seem to be applicable as an outcome measure for surgical reconstruction of manual dexterity.
研究脑瘫患儿手部灵活性受损与自我感知能力之间的关系，以及手术干预的效果，探讨自我感知能力是否可作为手部功能手术重建的一项结果指标。
对25例痉挛型偏瘫脑瘫儿童及青少年样本，使用荷兰语版的密歇根手部结果问卷（MHQ-DLV）评估手部灵活性感知，以及荷兰语版的哈特量表评估自我感知能力。10例患者接受了改善手部功能的手术治疗。在这个“手术组”中，两份问卷在术后至少一年进行了重复测量。
手部灵活性感知较低（平均MHQ-DLV得分：63.2；标准差：18.9），自我感知的总体能力得分（2.92；标准差：0.84）、社交能力得分（2.66；标准差：0.92）和运动能力得分（2.29；标准差：0.79）也较低。手部灵活性感知受损程度与自我感知能力之间无相关性（r = -0.16；p = 0.43）。手术重建后手部灵活性得到改善（平均得分增加：24；标准差：10.4；p < 0.01），但自我感知能力没有改善（p = 0.39）。
与无此障碍的儿童相比，手部灵活性受损的脑瘫患儿自我感知能力较低。手部灵活性受损程度与自我感知能力降低程度不相关。手术干预显著改善了手部灵活性感知，但自我感知能力没有改善。自我感知能力似乎不适用于作为手部灵活性手术重建的结果指标。
