Are mirror movements associated with bimanual hand function among children with unilateral spastic cerebral palsy?
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Children and adolescents with unilateral spastic cerebral palsy (USCP) may experience mirror movements (MM). The amount of MM may indicate differences in the organization of the cortico-spinal motor tracts, which may in turn affect the effectiveness of interventions aimed to improve hand function. However, it is unclear if MM affect bimanual hand function in this population. AIM: This study aimed to assess whether MM affected bimanual hand function in children with USCP. METHOD: Eligible to participate in this study, were children and adolescents with USCP. Children and adolescents were recruited from two sites: In Trondheim, Norway, a convenient sample of 18 children and adolescents (9 females; age range 12-20 y, mean 12.2 y) was recruited through the outpatient clinic. In Melbourne, Australia, further 18 patients with USCP participating in an on-going research project were recruited. Since the latter population, in several important aspects, turned out to be markedly different, from those recruited from the site in Trondheim, the present study was restricted to the Trondheim population. Bimanual performance was scored using the Assisting Hand Assessment (AHA), and manual capacity was scored using the Box and Block test (B&B). Mirror movements were scored clinically according to Woods and Teuber (W&T) based on video recordings. In addition, MM were assessed using a newly developed computerbased video analysis software. Mirror movements were then correlated with hand function. RESULTS: When MM were scored according to W&T, moderate to high negative correlations were found between MM and all measures of hand function (Spearmans’s rho ranging from - 0.50 to -0.66). When MM were measured using the computer-based method, only a low to moderate negative correlation was found between MM and capacity (B&B) in the affected hand (Spearman’s rho = -0.50). INTERPRETATION: Mirror movements in the affected and in the non-affected hand, affects bimanual performance and capacity in both hands negatively among children over the age of 10. Remove selected