Literature DB >> 23024728

Upper limb motion analysis in children with hemiplegic cerebral palsy: proximal kinematic changes after distal botulinum toxin or surgical treatments.

Frank Fitoussi1, Amadou Diop, Nathalie Maurel, El Mostefa Laasel, Brice Ilharreborde, Georges François Penneçot.   

Abstract

PURPOSE: The purpose of this study is to describe the kinematic changes in children with cerebral palsy (CP) after treatments performed on the forearm, wrist or thumb, with specific attention to the changes around the trunk, shoulder and elbow kinematics.
METHODS: With the use of a specific kinematic protocol, we first described the upper limb kinematics in a group of 27 hemiplegic patients during two simple daily tasks. Eight of these children were treated with botulinum toxin (Botox(®), Allergan) injection or surgery and were, thereafter, evaluated with another kinematic analysis in order to compare the pre- and post-therapeutic condition. The target muscles were the pronator teres, flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis, flexor pollicis longus and the adductor pollicis.
RESULTS: Significant kinematic changes were found after treatment. Patients increased forearm supination (P < 0.05) and wrist extension (P < 0.05) during both tasks. Patients also decreased trunk flexion/extension range of motion (ROM) (P < 0.05), improved elbow ROM (P < 0.05) and improved internal shoulder rotation (P < 0.05).
CONCLUSIONS: Dynamic shoulder or elbow limitations in children with mild hemiplegia involvement could be related to a compensatory movement strategy and/or co-contractions. As these proximal kinematics anomalies are improved after treatments performed at the forearm, wrist and thumb, they should not be treated first but should be reconsidered after the treatment of more distal problems.

Entities:  

Keywords:  Cerebral palsy; Hemiplegia; Kinematic analysis; Upper limb

Year:  2011        PMID: 23024728      PMCID: PMC3179533          DOI: 10.1007/s11832-011-0365-z

Source DB:  PubMed          Journal:  J Child Orthop        ISSN: 1863-2521            Impact factor:   1.548


  29 in total

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