Article

OBJECTIVE: To assess force coordination in children with hemiplegic cerebral
palsy (CP) using a device that allows for testing both unimanual and bimanual
manipulation tasks performed under static and dynamic conditions. DESIGN:
Nonequivalent groups design. SETTING: University research laboratory for motor
control. PARTICIPANTS: Six children with hemiplegic CP (age, mean +/- SD,
11.6+/-1.8 y) and 6 typically developing controls (11.6+/-1.6 y). INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Children performed simple lifting and
force-matching static ramp tasks by way of both unimanual and bimanual pulling
using a device that measures grip force (force acting perpendicularly at the
digits-device contact area) and load force (tangential force). Main outcome
measures were grip/load force ratios (grip force scaling) and correlation
coefficients (force coupling). RESULTS: CP subjects showed significantly higher
grip/load force ratios (P<.05) and slightly lower correlation coefficients than
the control group, with more pronounced differences for most tasks when using
their involved hand. For subjects with CP, switching from unimanual to bimanual
conditions did not bring changes in scaling or coupling for the involved hand
(P>.05). CONCLUSIONS: Compared with healthy children, the impaired hand function
in the hemiplegic CP pediatric population could be reflected in excessive grip
force that is also decoupled from ongoing changes in load force. Therefore, the
bimanual grip load device used in this study could provide a sensitive measure of
grip force coordination in CP, although nonmotor deficits should be taken into
account when asking children to perform more complex tasks.

Langue : ANGLAIS