Fifteen-year follow-up of upper limb function in children with moderate to severe traumatic brain injury.

OBJECTIVE To describe the impaired fine-motor skills in patients with traumatic brain injury acquired in childhood. DESIGN A total of 165 patients with traumatic brain injury, aged 0-17 years, injured during the period 1987-1991, were identified. Fifteen years post-injury a questionnaire was sent to the patients. Twenty-six of the subjects had upper limb problems, 15 of whom agreed to participate and 12 attended an evaluation. METHODS The Sollerman test was administered. This test consists of 20 activities, of which 7 hand-grips were used (pulp-pinch, lateral pinch, tripod pinch, 5-finger pinch, diagonal, transverse and spherical volar grip). Each sub-test was scored from 0 to 4 points. Each task must be performed within 20 s. The maximum score was 80. Bimanual fine motor skills were classified by Bimanual Fine Motor Function (BFMF). BFMF consists of 5 levels of function of each hand. Level I is normal function, level II-V means subnormal function in an increasing grade. Co-ordination, spasticity, 2PD and stereognosis were also measured. RESULTS All patients had subnormal results on the Sollerman test. Fifty-eight percent had abnormal scores on the BFMF test. CONCLUSION The Sollerman test seemed to be reliable at picking up hand motor problems, as all subjects who reported such problems scored subnormally. This is in contrast to the BFMF test findings, where only 60% of our group scored subnormally.