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. 2022 Nov;17(6):1114-1121.
doi: 10.1177/1558944721990803. Epub 2021 Feb 19.

Dexterity of the Less Affected Hand in Children With Hemiplegic Cerebral Palsy

Matthew B Burn  1   2 , Gloria R Gogola  2
Affiliations

Dexterity of the Less Affected Hand in Children With Hemiplegic Cerebral Palsy

Matthew B Burn et al. Hand (N Y). 2022 Nov.

Abstract

Background: To determine if the "unaffected" hand in children with hemiplegic cerebral palsy (CP) is truly unaffected.

Methods: We performed a retrospective review of manual dexterity as measured by the Functional Dexterity Test (FDT) in 66 children (39 boys, 27 girls, mean age: 11 years 4 months) with hemiplegic CP. Data were stratified by Manual Ability Classification System (MACS) level, birth weight, and gestational age at birth, and compared with previously published normative values.

Results: The FDT speed of the less affected hand is significantly lower than typically developing (TD) children (P < .001). The development of dexterity is significantly lower than TD children (0.009 vs. 0.036 pegs/s/year, P < .001), with a deficit that increases with age. MACS score, birth weight, and age at gestation are not predictors of dexterity. The dexterity of the less affected hand is poorly correlated with that of the more affected hand.

Conclusions: Both dexterity and rate of fine motor skill acquisition in the less affected hand of children with hemiplegic CP is significantly less than that of TD children. The less affected hand should be evaluated and included in comprehensive treatment plans for these children.

Keywords: Functional Dexterity Test; cerebral palsy; contralateral hand; dexterity; hemiplegia; less affected hand.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
FDT speed of the less affected hand in children with hemiplegic CP plotted against age and hand-dominance matched norms. Both CP and norm FDT speeds increase with age, but at significantly different rates. Note. FDT = Functional Dexterity Test; CP = cerebral palsy.
Figure 2.
Figure 2.
FDT speed of the less affected hands by MACS score compared with norms. There was no significant difference in the rate over time between MACS II or MACS III; they were both significantly slower than norms. Note. MACS = Manual Ability Classification System; FDT = Functional Dexterity Test.
Figure 3.
Figure 3.
FDT speeds for both the less affected and more affected hands compared to dominant and nondominant hand normative values. Note. The rate of dexterity development (slope) is conserved between the 2 hands in both cases; however, the constant difference between the 2 hands is more pronounced in children with CP. FDT = Functional Dexterity Test; CP = cerebral palsy.
See this image and copyright information in PMC

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