Article

Most surgical techniques intervene at the level of body functions of
the upper limb, aiming to improve manual capacity and activity performance.
However, the nature of the relationships among these levels of functioning and
evidence for hand function variables predicting performance have scarcely been
investigated. The primary aim of this study was to assess aspects of
hand function and manual capacity that influence bimanual performance in children
with congenital hand differences (CHDs), ranging from surgically corrected
polydactyly or syndactyly to radial dysplasia. A secondary aim was to assess
whether the number of items on the Prosthetic Upper Extremity Functional Index
(PUFI) can be reduced without losing information on bimanual performance in this
population. DESIGN: A cross-sectional design was used. METHODS: One hundred six
10- to 14-year-old children with CHD participated in the study, which was
conducted in a university hospital's outpatient clinic. Bimanual performance was
evaluated with child self-reports on an adapted version of the PUFI, calculating
ease of performance and actual use of the affected hand. Additionally, hand
function and manual capacity were assessed. RESULTS: The median score on ease of
performance was high, and, on average, the children used their affected hand
actively in 97% of all activities. Manual capacity of the nondominant hand and
lateral pinch strength of the dominant hand predicted attainment of maximum PUFI
scores. Nonmaximum PUFI scores were predicted by opposition strength of the
nondominant hand and lateral pinch strength of the dominant hand. In addition, in
this patient group, only 6 items of the PUFI explained all variance in PUFI
scores. LIMITATIONS: The generalizability of the results is limited by the
carefully selected age range. Second, the cross-sectional design of the study
limits statements on causality on the relationships found. CONCLUSION: Children
with a CHD generally have good bimanual performance and, on average, perform
activities with active use of the affected hand. Therapy directed toward
increasing manual capacity and finger muscle strength might assist in improving
bimanual performance in children with CHD. Furthermore, the number of items on
the PUFI could be reduced from 38 to 6 items in children with CHD.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS