Precision grip control, sensory impairments and their interactions in children with hemiplegic cerebral palsy: a systematic review. 2013

Yannick Bleyenheuft, and Andrew M Gordon
Institute of Neuroscience, Université catholique de Louvain, Belgium. yannick.bleyenheuft@uclouvain.be

Children with hemiplegic cerebral palsy (HCP) exhibit long-term functional deficits. One of the most debilitating is the loss of prehension since this may impair functional independence. This loss of prehension could be partly due to sensory deficits. Identifying the underlying causes of prehension deficits and their potential link with sensory disorders is important to better adapt neurorehabilitation. Here we provide an overview of precision grip and sensory impairments in individuals with HCP, and the relation between them, in order to determine whether the sensory impairments influence the type and magnitude of deficits as measured by studies of prehensile force control. Pubmed and Scopus databases were used to search studies from 1990 to 2012, using combinations of the following keywords: fingertip force; grip force; precision grip; sensory deficit; sensory impairment; tactile discrimination; with cerebral palsy. Of the 190 studies detected through the systematic search; 38 were finally included in the systematic part of this review. This review shows that sensory deficits are common and are likely underestimated using standard clinical assessments in HCP. Some studies suggest these deficits are the basis of predictive motor control impairments in these individuals. However, children with HCP retain some ability to use predictive control, even if it is impaired in the more affected hand. Intensive practice and initial use of the less affected hand, which has only subtle sensory deficits, has been shown to remediate impairments in anticipatory motor control during subsequent use of the more affected hand. Implications for motor and sensory rehabilitation of individuals with HCP are discussed.

UI MeSH Term Description Entries
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006429 Hemiplegia Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; and other conditions may manifest as hemiplegia. The term hemiparesis (see PARESIS) refers to mild to moderate weakness involving one side of the body. Monoplegia,Hemiplegia, Crossed,Hemiplegia, Flaccid,Hemiplegia, Infantile,Hemiplegia, Post-Ictal,Hemiplegia, Spastic,Hemiplegia, Transient,Crossed Hemiplegia,Crossed Hemiplegias,Flaccid Hemiplegia,Flaccid Hemiplegias,Hemiplegia, Post Ictal,Hemiplegias,Hemiplegias, Crossed,Hemiplegias, Flaccid,Hemiplegias, Infantile,Hemiplegias, Post-Ictal,Hemiplegias, Spastic,Hemiplegias, Transient,Infantile Hemiplegia,Infantile Hemiplegias,Monoplegias,Post-Ictal Hemiplegia,Post-Ictal Hemiplegias,Spastic Hemiplegia,Spastic Hemiplegias,Transient Hemiplegia,Transient Hemiplegias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012678 Sensation Disorders Disorders of the special senses (i.e., VISION; HEARING; TASTE; and SMELL) or somatosensory system (i.e., afferent components of the PERIPHERAL NERVOUS SYSTEM). Sensory Disorders,Special Senses Disorders,Sensation Disorder,Senses Disorder, Special,Senses Disorders, Special,Sensory Disorder,Special Senses Disorder
D014110 Touch Sensation of making physical contact with objects, animate or inanimate. Tactile stimuli are detected by MECHANORECEPTORS in the skin and mucous membranes. Tactile Sense,Sense of Touch,Taction,Sense, Tactile,Senses, Tactile,Tactile Senses,Tactions,Touch Sense,Touch Senses
D018737 Hand Strength Force exerted when gripping or grasping. Grasp,Grip,Grip Strength,Hand Grip Strength,Grasps,Grip Strength, Hand,Grips,Strength, Grip,Strength, Hand,Strength, Hand Grip

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