Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
Dev Med Child Neurol. 2021 May;63(5):576-583. doi: 10.1111/dmcn.14783. Epub 2020 Dec 22.
To examine the relationship between self-care and bimanual performance in children aged 8 to 12 years with cerebral palsy (CP).
This was a cross-sectional study of 74 children with CP (unilateral n=30, bilateral n=44; 48 males, 26 females; median age 9y 8mo [25th, 75th centiles 9y 1mo, 10y 8mo], Manual Abilities Classification System level I=30, II=28, III=16). Self-care was measured using the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), and bimanual performance using the Assisting Hand Assessment (AHA) and Both Hands Assessment (BoHA). Measures of cognition, behavioural regulation, inattention, and gross motor function were included. Analyses used a directed acyclic graph to select variables for linear regression modelling.
Higher AHA and BoHA scores were associated with higher PEDI-CAT scores. An increase of 1 AHA unit was associated with an increase of 0.12 PEDI-CAT scores, and a 1 BoHA unit increase was associated with an increase of 0.17 PEDI-CAT scores. The BoHA accounted for 57% of variance in PEDI-CAT scores for children with bilateral CP, while BoHA and cognition accounted for 68% of variance. The AHA accounted for 40% of variance in PEDI-CAT scores for unilateral CP with no effect of cognition on self-care.
Self-care was strongly and positively associated with bimanual performance. Associations between self-care and bimanual performance differed for those with unilateral and bilateral CP.
There is a strong positive relationship between self-care and bimanual performance for unilateral and bilateral cerebral palsy (CP). Both Hands Assessment (BoHA) scores have a stronger association with self-care than Assisting Hand Assessment scores. BoHA scores also account for more variation in self-care. There is a strong positive relationship between self-care and cognition overall. The effect of cognition on self-care performance differed for bilateral and unilateral CP.
研究 8 至 12 岁脑瘫儿童（CP）的自我护理与双手表现之间的关系。
这是一项 74 名 CP 儿童（单侧 n=30，双侧 n=44；男 48 名，女 26 名；中位年龄 9 岁 8 个月[25 百分位数，75 百分位数 9 岁 1 个月，10 岁 8 个月]，手功能分级系统Ⅰ级=30 例，Ⅱ级=28 例，Ⅲ级=16 例）的横断面研究。自我护理采用小儿残疾评估量表-计算机自适应测试（PEDI-CAT）进行评估，双手表现采用辅助手评估（AHA）和双手评估（BoHA）进行评估。包括认知、行为调节、注意力不集中和粗大运动功能的测量。分析使用有向无环图选择线性回归模型的变量。
较高的 AHA 和 BoHA 评分与较高的 PEDI-CAT 评分相关。AHA 每增加 1 个单位，PEDI-CAT 评分增加 0.12 分，BoHA 每增加 1 个单位，PEDI-CAT 评分增加 0.17 分。BoHA 占双侧 CP 儿童 PEDI-CAT 评分方差的 57%，而 BoHA 和认知占 68%。AHA 占单侧 CP 儿童 PEDI-CAT 评分方差的 40%，认知对自我护理无影响。
自我护理与双手表现呈强烈正相关。单侧和双侧 CP 患者的自我护理与双手表现之间存在关联。
单侧和双侧脑瘫（CP）患者的自我护理与双手表现呈正相关。双手评估（BoHA）评分与自我护理的相关性强于辅助手评估评分。BoHA 评分也能更好地预测自我护理。整体上，自我护理与认知呈正相关。认知对自我护理表现的影响在双侧和单侧 CP 中有所不同。
