Cerebral Palsy, Hemiplegic
Conditions
Keywords
cerebral palsy, sensory function, motor function
Brief summary
Cerebral palsy (CP) is characterized by many problems related to brain damage. One of these is sensory impairment. Sensory impairments in CP patients can also occur together with motor functions. Detecting sensory impairments (two-point discrimination, vibration, joint position sense, thermal sensation, stereognosis, graphesthesia) in the arm, forearm, and hand (upper extremity) in CP patients and investigating their relationship with motor functions is important. The aim of this research is to investigate the relationship between upper extremity sensory impairments and motor functions in patients diagnosed with unilateral (affecting one half of the body) CP.
Detailed description
The aim of this study is to investigate the relationship between sensory impairments and upper extremity motor functions in patients with unilateral cerebral palsy (CP). It will be planned as a cross-sectional study. The study will include 55 unilateral CP patients and 55 healthy volunteers. Sensory functions evaluated include two-point discrimination, joint position sense, vibration sense, thermal sense, stereognosis, and graphesthesia. Motor functions will be assessed using the Gross Motor Functional Classification System (GMFSS), Hand Skills Classification System (ESCS), Abilhand-Kids scale, Box and Block test, and Nine Hole Peg test. The relationship between sensory parameters and motor functions will be investigated.
Interventions
None listed
Sponsors
Ankara University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
6 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
* Children aged 15 with unilateral cerebral palsy (CP) * Being between Gross Motor Functional Classification System I-IV * Not having undergone surgery or botulinum toxin application to the affected upper extremity in the last 6 months * Understanding what is said and being able to follow commands * The patient or their relatives having completed an informed consent form
Exclusion criteria
* Having a neurological disease affecting the motor and sensory system other than cerebral palsy * The participant having a dermatological, vascular, or orthopedic problem in the upper extremity that would prevent assessment * Having uncorrected vision and hearing problems * Having autism spectrum disorder and attention deficit hyperactivity disorder * Having insufficient intelligence level
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensory Function:Two-point discrimination | Single assessment at baseline (cross-sectional evaluation) | Two-point discrimination is defined as the ability to distinguish between two simultaneous points of touch, which is most acute in areas of the skin with a high density of touch receptors, such as the fingers and face. The test will be performed using a discriminator device called an esthesiometer. |
| Sensory Function:Joint position sense | Single assessment at baseline (cross-sectional evaluation) | Joint position sense is the ability to detect body segment position in space and is commonly used to represent proprioceptive performance. |
| Sensory Function:Vibration | Single assessment at baseline (cross-sectional evaluation) | Assessment of vibration sense is the best clinical test of the dorsal column pathway. A low-frequency (128 Hz) tuning fork is applied to bony prominences and the patient (with closed eyes) is asked to report when the vibration starts and stops. |
| Sensory Function:thermal sense | Single assessment at baseline (cross-sectional evaluation) | The volunteer's upper extremity is successively touched with tubes filled with hot and cold water, and the volunteer is asked to respond as hot or cold. Thermal sensation is recorded as 'preserved', 'impaired', or 'unable to assess'. |
| Sensory Function:Stereognosis | Single assessment at baseline (cross-sectional evaluation) | Without visual or auditory cues, objects are placed in a sequence, and the child is asked to grasp them and identify the name of the object. Each object is awarded '1' point for being correctly identified, and '0' points for not identifying it. Scores ranging from 0 to 6 are recorded. |
| Sensory Function:Graphesthesia | Single assessment at baseline (cross-sectional evaluation) | Six different drawings-letters, numbers, circles, and vertical lines-are made on the palm of the volunteer's hand using a blunt pencil, without any visual or auditory stimuli. Each correct drawing earns '1' point, and each incorrect drawing earns '0' points. Scores ranging from 0 to 6 are recorded. |
| Motor Function: Gross Motor Functional Classification System | Single assessment at baseline (cross-sectional evaluation) | This classification system consists of 5 levels. |
| Motor Function: Hand Skills Classification System | Single assessment at baseline (cross-sectional evaluation) | This classification system consists of 5 levels. |
| Motor Function: Abilhand-Kids Scale | Single assessment at baseline (cross-sectional evaluation) | Twenty-one daily activities were evaluated. Participants were asked to rate an activity-which the child attempted to perform independently using both upper extremities-on a scale of 0-42 points. |
| Motor Function: Nine Hole Peg Test | Single assessment at baseline (cross-sectional evaluation) | The Nine Hole Peg Test was developed to measure finger dexterity, also known as fine manual dexterity. The test consists of a wooden board with nine holes and nine small sticks designed to be inserted into those holes. The participant is asked to take the sticks from the box one by one with the hand being tested and insert them into the holes as quickly as possible; then, they must remove the sticks one by one and return them to the box. |
| Motor Function: Box and Block Test | Single assessment at baseline (cross-sectional evaluation) | The Box and Block Test (BBT) measures unilateral gross manual dexterity. Participants are given 60 seconds to move wooden blocks by hand to the opposite compartment as quickly as possible. At the end of 60 seconds, the number of wooden blocks transferred to the opposite compartment is noted. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORBirkan Sonel Tur, Professor
Ankara University, Faculty of Medicine
Outcome results
None listed