To Find Out the Relation between Hand Impairments and Activity Limitations of Spastic Diplegic Grasp Patterns

Although, spasticity may be one of the features in spastic diplegic cerebral pasly population, children also show atypical hand movements, reduced gross and fine motor skills, which could be because of various other impairments. At the body level, other impairment measurements include, Range of Motion (ROM), muscle tone, muscle strength and sensory integration. Search of literature does not provide any studies that directly relate to these underlying hand impairments and activity limitations in diplegic children. Hence, there is a need to relate the above impairments to activities of hand. The objective of this study is to find the relation between impairments and activity limitations of hand function in spastic diplegic cerebral palsy children. An observational cross sectional study design. 58 subjects were included, both the genders, between the age group of 6 – 12 years, of all the GMFCS levels, with or without splints, with or without surgery for forearm and who can sit independently were included. Children who were visually impaired, hearing impaired and with cognitive impairments were excluded. The study was conducted in the RECOUP neuro musculo skeletal rehabilitation centre, Bangalore. Subjects were tested for their sensory evaluation with Nottingham sensory evaluation chart, muscle tone using Modified ash worth scale , range of motion with goniometer , grip strength with a Jamar Dynamometer, pinch strength with a pinchometer ,pain using NPRS and hand activities with the help of Sollerman Hand Function test, were assessed and correlated and regression was done statistically. The results showed, that there was a moderate positive relation between sollerman hand function test to that of ROM, grip and pinch strength with p < 0.01. But, there was a negative relation with hand function test to that of sensory impairment, muscle tone and pain. When multivariant regression was done, it was shown that only grip strength showed a considerable variation of 31.9% with respect to the other variables to the hand function. Thus, there was no significant statistical variation between the relations of the variables.