Clinical Factors Related to Upper Extremity Shortness in Children With Hemiplegic Cerebral Palsy

차영선; Shin， Yong-Beom; KO，HYUN-YOON; SHIN， YONG IL; Chang-Hyung Lee; Chang， Jae-hyeok; Shin， Myung-Jun; 문정인

Korean Journal of Occupational Therapy

Abbr : Korean J of Occup Ther
2013, 21(2), pp.25-36
Publisher : Korean Society Of Occupational Therapy
Research Area : Working Therapeutics

차영선 ¹ , Shin， Yong-Beom ² , KO，HYUN-YOON ³ , SHIN， YONG IL ⁴ , Chang-Hyung Lee ⁵ , Chang， Jae-hyeok ⁶ , Shin， Myung-Jun ⁷ , 문정인 ⁸

¹ 부산대학교 의학전문대학원 재활의학교실
² 부산대학교
³ 부산대학교
⁴ 부산대학교
⁵ 부산대학교
⁶ 부산대학교
⁷ 부산대학교병원
⁸ 양산부산대학교병원 작업치료실

ABSTRACT

Objective : The purpose of this paper is to investigate the upper extremity shortness in people with hemiplegic cerebral palsy (HCP) compared with a normal control group, and evaluate the correlations between extremity shortness, muscle tone, and functional activity. Methods : This study included 30 children with HCP (13 males, 17 females; mean age, 6.33 yr)and 17 normal children as a control (9 males, 8 females; mean age, 6.17 yr). The length of each limb segment composed of the humerus, ulna, radius, and the second and fifth metacarpal bones was measured for both the patients and and control group using a radiograph. The discrepancy in side-to side length was calculated as a percentage. The Modified Ashworth Scale (MAS) was used in the evaluation of spasticity, and the Quality of Upper Extremity Skills Test (QUEST) was used in the evaluation of functional ability. Results : Upper extremity shortness differed significantly between the patients and control group (p<.05). The percentage differences in bone length correlated positively with the MAS point,and negatively with QUEST score in each limb segment (p<.05). Conclusion : The hemiplegic upper limb length discrepancy correlated with the functional activity and spasticity of the upper limb. Further studies to evaluate the change in upper extremity shortness after functional improvement and spasticity management will help to demonstrate the effect of rehabilitative treatment and determine the method and intensity of therapy required.
KEYWORDS

Bones of upper extremity , Cerebral palsy , Hemiplegia , Motor activity , Muscle spasticity
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