Article

The objective of this study was to characterize normal temporal-spatial patterns
during the Reach & Grasp Cycle and to identify upper limb motor deficits in
children with cerebral palsy (CP). The Reach & Grasp Cycle encompasses six
sequential tasks: reach, grasp cylinder, transport to self (T(1)), transport back
to table (T(2)), release cylinder, and return to initial position.
Three-dimensional motion data were recorded from 25 typically developing children
(11 males, 14 females; ages 5-18 years) and 12 children with hemiplegic CP (2
males, 10 females; ages 5-17 years). Within-day and between-day coefficients of
variation for the control group ranged from 0 to 0.19, indicating good
repeatability of all parameters. The mean duration of the Cycle for children with
CP was nearly twice as long as controls, 9.5+/-4.3s versus 5.1+/-1.2s (U=37.0,
P=.002), partly due to prolonged grasp and release durations. Peak hand velocity
occurred at approximately 40% of each phase and was greater during the transport
(T(1), T(2)) than non-transport phases (reach, return) in controls (P<.001).
Index of curvature was lower during transport versus non-transport phases for all
children. Children with CP demonstrated an increased index of curvature during
reach (U=46.0, P=.0074) and an increased total number of movement units (U=16.5,
P<.0001) compared to controls, indicating less efficient and less smooth
movements. Total duration of the Reach & Grasp Cycle (rho=.957, P<.0001), index
of curvature during reach and T(1) (rho=.873, P=.0002 and rho=.778, P=.0028), and
total number of movement units (rho=.907, P<.0001) correlated strongly with MACS
score. The consistent normative data and the substantial differences between
children with CP and controls reflect utility of the Reach & Grasp Cycle for
quantitative evaluation of upper limb motor deficits.
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