Klevberg Gunvor L, Østensjø Sigrid, Krumlinde-Sundholm Lena, Elkjær Sonja, Jahnsen Reidun B
a Research Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society , University of Oslo , Oslo , Norway.
b Faculty of Health Sciences , Oslo and Akershus University College of Applied Sciences , Oslo , Norway.
Phys Occup Ther Pediatr. 2017 Oct 20;37(5):528-540. doi: 10.1080/01942638.2017.1280873. Epub 2017 Mar 20.
To describe aspects of hand function in a population-based sample of young children with clinical signs of unilateral or bilateral cerebral palsy (CP).
A cross-sectional study with data from national CP registers in Norway. Manual ability was classified with the Manual Ability Classification System (MACS) or Mini-MACS. Hand use in bimanual activities was measured with the Assisting Hand Assessment (AHA) for unilateral CP or the newly developed Both Hands Assessment (BoHA) for bilateral CP.
From 202 children, 128 (57 females) were included (Mini-MACS/MACS levels I-V, mean age 30.4 months; SD = 12.1). Manual abilities were distributed across levels I-III in unilateral CP and levels I-V in bilateral CP. Variations in AHA and BoHA units were large. One-way ANOVA revealed associations between higher AHA or BoHA units and Mini-MACS/MACS levels of higher ability (p < 0.01) and higher age (p < 0.04).
Compared with young children with unilateral CP, children with bilateral CP showed greater variation in Mini-MACS/MACS levels, and both sub-groups showed large variations in AHA or BoHA units. The classifications and assessments used in this study are useful to differentiate young children's ability levels. Such information is important to tailor upper limb interventions to the specific needs of children with CP.
描述以单侧或双侧脑瘫（CP）临床症状为基础的幼儿群体样本中的手部功能情况。
一项横断面研究，数据来自挪威全国脑瘫登记处。使用手动能力分类系统（MACS）或迷你MACS对手部能力进行分类。对于单侧脑瘫，使用辅助手评估（AHA）来测量双手活动中的手部使用情况；对于双侧脑瘫，则使用新开发的双手评估（BoHA）。
从202名儿童中，纳入了128名（57名女性）（迷你MACS/MACS水平I-V，平均年龄30.4个月；标准差=12.1）。单侧脑瘫的手部能力分布在I-III级，双侧脑瘫的手部能力分布在I-V级。AHA和BoHA单位的差异很大。单因素方差分析显示，较高的AHA或BoHA单位与较高能力的迷你MACS/MACS水平（p<0.01）和较高年龄（p<0.04）之间存在关联。
与单侧脑瘫幼儿相比，双侧脑瘫儿童在迷你MACS/MACS水平上表现出更大的差异，且两个亚组在AHA或BoHA单位上均表现出较大差异。本研究中使用的分类和评估有助于区分幼儿的能力水平。这些信息对于根据脑瘫儿童的特定需求定制上肢干预措施非常重要。
