Impact of Tactile Dysfunction on Upper-Limb Motor Performance in Children With Unilateral Cerebral Palsy

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• 作者：Megan L. Auld ; PhD^a ; ^d ; ^{mauld@uq.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Roslyn N. Boyd ; PhD^b ; G. Lorimer Moseley ; PhD^e ; ^f ; Robert S. Ware ; PhD^c ; ^g ; Leanne M. Johnston ; PhD^a ; ^d
• 关键词：Arm ; Cerebral palsy ; Hemiplegia ; Perception ; Rehabilitation ; Sensation ; Touch
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2012
• 出版时间：April 2012
• 年：2012
• 卷：93
• 期：4
• 页码：696-702
• 全文大小：671 K

文摘

Auld ML, Boyd RN, Moseley GL, Ware RS, Johnston LM. Impact of tactile dysfunction on upper-limb motor performance in children with unilateral cerebral palsy.

Objective

To determine the relationship between tactile function and upper-limb function in children with unilateral cerebral palsy (CP).

Design

Cross-sectional study.

Setting

Assessments were performed in community or hospital venues or in participants' homes.

Participants

Recruitment information was sent to 253 possible participants with unilateral CP (aged 8–18y), and N=52 participated (median age [interquartile range], 12y [9–14y]; Gross Motor Functional Classification System level I=34; II=18; Manual Abilities Classification Scale level I=36; II=16).

Interventions

Not applicable.

Main Outcome Measures

Tactile assessment included 1 test of registration, 5 tests for spatial perception, and 1 test for texture perception. Upper-limb motor function was assessed using 2 unimanual tests, the Melbourne Unilateral Upper Limb Assessment (MUUL) and Jebsen-Taylor Test of Hand Function (JTTHF), and 1 bimanual test, the Assisting Hand Assessment (AHA).

Results

Tactile registration and all tests of spatial perception were moderately related to the MUUL, JTTHF, and AHA (P<.001). Texture perception was not related to upper-limb motor function. Regression analysis showed that single point localization, a unilateral tactile spatial perception test, contributed most strongly to unimanual capacity (29% explained variance in MUUL and 26% explained variance in JTTHF), whereas double simultaneous, a bilateral tactile spatial perception test, contributed most strongly to bimanual performance (33% for the AHA).

Conclusions

Spatial tactile deficits account for approximately 30% of the variance in upper-limb motor function in children with unilateral CP. This emphasizes the need for routine tactile assessment and targeted treatment of tactile spatial deficits in this population.