Article

The aim of this study was to describe how the usefulness of the hemiplegic
hand develops in children with unilateral cerebral palsy (CP) aged between 18
months and 8 years. METHOD: A prospective longitudinal study of 43 children (22
males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months
to 5 years 4 months (mean 2y 8mo [SD 1y 1mo]). Children were assessed with the
Assisting Hand Assessment (AHA) 3 to 11 times per child over a mean period of 4
years 6 months. Two models were used for grouping children: by AHA score at 18
months and by Manual Ability Classification System (MACS) levels. Estimated
average motor development curves were fitted with a nonlinear mixed-effects
model. RESULTS: Children with a high AHA score (high ability level) at 18 months
reached a significantly higher ability level and at a higher progression rate
than children with a low 18-month AHA score. Limits of development differed
between the three MACS levels. INTERPRETATION: Results indicate that the AHA
score at 18 months can be used to discuss future development of affected hand use
in bimanual tasks in children with unilateral CP.

Langue : ANGLAIS