To Find Out Incidence & Pattern of Upper Limb Involvement In Cerebral Palsy

Abstract

upper limb involvement in children with cerebral palsy (CP). Methodology: 100 consecutive patients with CP attending clinics were assessed. Function was assessed according to the Gross Motor Functional Classification System (GMFCS), the Manual Ability Classification System (MACS) and the ABILHAND-Kids system and correlated to age and pattern of upper limb involvement. Patients were examined for contractures in the shoulder, elbow, wrist and hand. Concerns about the appearance of the hand were also assessed in older children. Result: Overall 83% of patients had upper limb involvement, 36% had a demonstrable contracture and 69% had reduced hand control. The most common contracture patients were the thumb in palms with clasp hand pattern was associated with the greatest functional disability followed by wrist flexion with pronation. Single contractures such as elbow flexion caused significant disability, whereas swan neck contractures were by far less debilitating. Children aged 12 years and older had more concerns about the appearance of their hand. The ABILHAND score was strongly correlated to both the GMFCS and the MACS score. Conclusion: different patterns of upper limb involvement exist in CP and some have a significant impact on function and cause cosmetic concerns that should not be underestimated particularly in older children.