Influence of visual-coupling on bimanual coordination in unilateral spastic cerebral palsy.

Controlling two objects simultaneously during a bimanual task is a cognitively demanding process; both hands need to be temporally and spatially coordinated to achieve the shared task goal. Children with unilateral spastic cerebral palsy (USCP) exhibit severe sensory and motor impairments to one side of their body that make the process of coordinating bimanual movements particularly exhausting. Prior studies have shown that performing visually-coupled task could reduce cognitive interference associated with performing 'two tasks at once' in an uncoupled bimanual task. For children with USCP, who also present with cognitive delay, performing this type of task may allow them to process and plan their movement faster. We tested this hypothesis by examining the grip force control of 7 children with USCP during unimanual and visually-coupled bimanual tasks. Results demonstrated that despite the visual coupling, the bimanual coordination of these children remained impaired. However, there may be a potential benefit of visually-coupled task in encouraging both hands to initiate in concert. The implication of the study for children with USCP is discussed.