Bingol Hasan, Fidan Hande, Asena Sel Sinem, Burc Eda, Gunel Mintaze Kerem
Department of Therapy and Rehabilitation, Vocational School of Health Services, Mus Alparslan University, Muş, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
Br J Occup Ther. 2024 Sep;87(9):546-555. doi: 10.1177/03080226241265254. Epub 2024 Jul 27.
Although most children with unilateral cerebral palsy can achieve independent mobility levels with or without assistive devices, they remain susceptible to decreased participation. This study aimed to explore the potential factors affecting participation of children with unilateral cerebral palsy.
Fifty children with unilateral cerebral palsy were enrolled. The degree of spasticity in the upper limb muscles was assessed using the Modified Ashworth Scale, active range of motion of the upper limb joints was assessed using a universal goniometer, and activity performance was measured using the ABILHAND-Kids and Gross Motor Function Measure. Environmental factors and mental health were evaluated using the European Child Environment Questionnaire and Strength and Difficulties Questionnaire. The Child and Adolescent Scale of Participation was used to assess participation.
Path analysis showed that upper limb impairment had both direct (β = -0.41; < 0.05) and indirect (β = 0.64; < 0.001) effects on participation. Most importantly, it was found that the participation of children with unilateral cerebral palsy was notably influenced by environmental factors and mental health (β = -0.42; < 0.05, and β = -0.36; < 0.05).
Participation of children with unilateral cerebral palsy is affected by a combination of functioning and contextual factors.
尽管大多数单侧脑瘫儿童无论有无辅助设备都能达到独立移动水平，但他们参与度降低的风险依然存在。本研究旨在探讨影响单侧脑瘫儿童参与度的潜在因素。
招募了50名单侧脑瘫儿童。使用改良Ashworth量表评估上肢肌肉痉挛程度，使用通用角度计评估上肢关节的主动活动范围，并使用ABILHAND-Kids和粗大运动功能测量量表测量活动表现。使用欧洲儿童环境问卷和长处与困难问卷评估环境因素和心理健康状况。使用儿童和青少年参与度量表评估参与度。
路径分析表明，上肢功能障碍对参与度既有直接影响（β = -0.41；<0.05），也有间接影响（β = 0.64；<0.001）。最重要的是，发现单侧脑瘫儿童的参与度受到环境因素和心理健康的显著影响（β = -0.42；<0.05，以及β = -0.36；<0.05）。
单侧脑瘫儿童的参与度受到功能因素和环境因素的综合影响。
