Tomhave Wendy A, Van Heest Ann E, Bagley Anita, James Michelle A
Shriners Hospital for Children-Twin Cities, Minneapolis, MN; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN; Motion Analysis Laboratory, Shriners Hospital for Children-Northern California, Sacramento, CA; Department of Orthopaedic Surgery, University of California, Davis, School of Medicine, Sacramento, CA.
Shriners Hospital for Children-Twin Cities, Minneapolis, MN; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN; Motion Analysis Laboratory, Shriners Hospital for Children-Northern California, Sacramento, CA; Department of Orthopaedic Surgery, University of California, Davis, School of Medicine, Sacramento, CA.
J Hand Surg Am. 2015 May;40(5):900-7. doi: 10.1016/j.jhsa.2014.12.039. Epub 2015 Mar 6.
To determine how the affected hemiplegic hand and contralateral dominant hand in children with hemiplegic cerebral palsy compare with age-matched norms for grip strength, pinch strength, and dexterity.
We enrolled 37 children with hemiplegic cerebral palsy (26 boys; average age, 9.8 y). Grip and pinch strength and Box and Blocks Test for dexterity were measured in both hands. Affected and contralateral hands results were analyzed and compared with each other and with norms for age and sex.
Affected hands had significantly less grip and pinch strength than the contralateral hands. Subjects transported significantly fewer blocks in one minute with the Box and Blocks Test (mean, 10.8 blocks) with the affected hand than the contralateral hand. Compared with normative values, affected-side grip and pinch strengths were significantly less, whereas contralateral hand grip and pinch strengths were similar. Dexterity in both affected and contralateral hands was significantly less than normative values. Decreased dexterity in the contralateral hand was correlated with decreased nonverbal intelligence quotient.
Dexterity of the contralateral hand is diminished in children with hemiplegia. Assessment of the contralateral hand may reveal opportunities for therapeutic intervention that improve fine motor function.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
确定偏瘫型脑瘫患儿患侧偏瘫手及对侧优势手在握力、捏力和灵活性方面与年龄匹配的正常标准相比情况如何。
我们纳入了37例偏瘫型脑瘫患儿（26名男孩；平均年龄9.8岁）。对双手进行握力、捏力测量以及用于评估灵活性的方块搭积木测试。对患侧手和对侧手的结果进行分析，并相互比较，同时与年龄和性别的正常标准进行比较。
患侧手的握力和捏力明显低于对侧手。在方块搭积木测试中，受试者用患侧手在一分钟内搬运的积木明显少于对侧手（平均为10.8块）。与正常标准值相比，患侧手的握力和捏力明显较低，而对侧手的握力和捏力则与之相似。患侧手和对侧手的灵活性均明显低于正常标准值。对侧手灵活性降低与非语言智商降低相关。
偏瘫患儿对侧手的灵活性降低。对对侧手进行评估可能会发现改善精细运动功能的治疗干预机会。
研究类型/证据水平：治疗性IV级。
