Index > Vol. 39/2007 > Iss. 8/October > pp. 598-604 > Abstract
Original report | Other brain injuries

Grip strength parameters and functional activities in young adults with unilateral cerebral palsy compared with healthy subjects

doi: 10.2340/16501977-0095

Abstract:

Objective: To determine reliability of maximal grip strength, muscle coordination and muscle endurance. To compare these parameters in young adults with unilateral cerebral palsy and healthy subjects. To evaluate the correlation of these variables with functional activities.
Subjects: Twenty-six healthy subjects and 26 young adults with unilateral cerebral palsy recruited from a cohort study in young adults with cerebral palsy.
Methods: Maximal grip strength, muscle coordination and muscle endurance were measured in both hands of all subjects. In the healthy subjects test-retest reliability was established. In the young adults with cerebral palsy, the Melbourne assessment and Abilhand Questionnaire were used to determine functional activities.
Results: For the dominant and non-dominant hand the intraclass correlation coefficients for the maximal grip strength were 0.93 and 0.91, for the muscle coordination 0.81 and 0.86, and for the muscle endurance 0.59 for both sides. Maximal grip strength of the involved hand of patients was reduced compared with the uninvolved hand and compared with healthy subjects. There was no difference in muscle coordination and muscle endurance between the involved and uninvolved hands. These parameters, however, were significantly reduced in both hands compared with healthy subjects. Correlations between grip strength parameters and activity limitations were relatively weak and non-linear.
Conclusion: Performance of activity is not directly related to grip strength parameters. The uninvolved hand of young adults with unilateral cerebral palsy also has impaired function.

Authors:

Jetty van Meeteren, Rogier M. van Rijn, Ruud W. Selles, Marij E. Roebroeck and Henk J. Stam

Key words:

grip strength, cerebral palsy, functional activities.

References

  1. Krägeloh-Mann I, Hagberg G, Meisner C, Schelp B, Haas G, Eeg-Olofson KE, et al. Bilateral spastic cerebral palsy – a comparative study between south-west Germany and western Sweden. I: clinical patterns and disabilities. Dev Med Child Neurol 1993; 35: 1037–1047.
  2. Krägeloh-Mann I, Hagberg G, Meisner C, Schelp B, Haas G, Eeg-Olofson KE, et al. Bilateral spastic cerebral palsy – a comparative study between south-west Germany and western Sweden. II: epidemiology. Dev Med Child Neurol 1994; 36: 473–483. 
.
  3. Mutch L, Alberman E, Hagberg B, Kodama K, Perat M. Cerebral palsy epidemiology: where are we now and where are we going? Dev Med Child Neurol 1992; 34: 547–555.
  4. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 2005; 47: 571–576.
  5. Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil 2006; 28: 183–191.
  6. Fedrizzi E, Pagliano E, Andreucci E, Oleari G. Hand function in children with hemiplegic cerebral palsy: prospective follow-up and functional outcome in adolescence. Dev Med Child Neurol 2003; 45: 85–91.
  7. Beckung E, Hagberg G. Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol 2002; 44: 309–316.
  8. Clerke A, Clerke J. A literature review of the effect of handedness on isometric grip strength differences of the left and right hands. Am J Occup Ther 2001; 55: 206–211.
  9. Schreuders TAR, Roebroeck ME, Goumans J, van Nieuwenhijzen JF, Stijnen TH, Stam HJ. Measurement error in grip and pinch force measurements in patient with hand injuries. Phys Ther 2003; 83: 806–815.
  10. Crosby CA, Wehbé MA, Mawr B. Hand strength: normative values. J Hand Surg 1994; 19A: 665–670.
  11. Valvano J, Newell KM. Practice of a precision isometric grip-force task by children with spastic cerebral palsy. Dev Med Child Neurol 1998; 40: 464–473.
  12. Gordon AM, Lewis SR, Eliasson AC, Duff SV. Object release under varying task constraints in children with hemiplegic cerebral palsy. Dev Med Child Neurol 2003; 45: 240–248.
  13. Eliasson AC, Gordon AM. Impaired force coordination during object release in children with hemiplegic cerebral palsy. Dev Med Child Neurol 2000; 42: 228–234.
  14. Steenbergen B, Meulenbroek RGJ, Rosenbaum DA. Constraints on grip selection in hemiparetic cerebral palsy: effects of lesional side, end-point accuracy, and context. Cognitive Brain Res 2004; 19: 145–159.
  15. Brown JV, Schumacher U, Rohlmann A, Ettlinger G, Schmidt RC, Skreczek W. Aimed movements to visual targets in hemiplegic and normal children: is the ”good” hand of children with infantile hemiplegia also normal? Neuropsych 1989; 22: 283–302.
  16. Gordon AM, Charles J, Duff SV. Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. II: Bilateral coordination. Dev Med Child Neurol 1999; 41: 176–185. Link to article
  17. Glees P, Cole J. Ipsilateral representation in the cerebral cortex. Lancet 1952; 1: 1191–1192.
  18. Kurillo G, Zupan A, Bajd T. Force tracking system for the assessment of grip force control in patients with neuromuscular diseases. Clin Biomech 2004; 19: 1014–1021.
  19. Schwid SR, Thornton CA, Pandya S, Manzur KL, Sanjak M, Petrie MD, et al. Quantitative assessment of motor fatigue and strength in MS. Neurology 1999; 53: 743–750.
  20. Adams J, Burridge J, Mullee M, Hammond A, Cooper C. Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population. Clin Rehabil 2004; 18: 405–431.
  21. Jaquet JB, Luijsterburg AJM, Kalmijn S, Kuypers PDL, Hofman A, Hovius SER. Median, ulnar, and combined median-ulnar nerve injuries: functional outcome and return to productivity. J Trauma 2001; 51: 687–692.
  22. Bruyns CNP, Jaquet JB, Schreuders TAR, Kalmijn S, Kuypers PDL, Hovius SER. Predictors for return to work in patients with median and ulnar nerve injuries. J Hand Surg [Am] 2003; 28A: 28–34.
  23. World Health Organization. International classification of functioning, disability and health. Geneva: WHO; 2001.
  24. Donkervoort M, Roebroeck M, Wiegerink D van der Heijden H, Stam H and the Transition Research Group South West Netherlands. Determinants of functioning of adolescents and young adults with cerebral palsy. Disabil Rehabil 2007; 29: 453–463. 
.
  25. SCPE: Surveillance of cerebral palsy in Europe. a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol 2000; 42: 816–824.
  26. Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol 2000; 42: 292–296.
  27. Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall, Rosenbaum P. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 2006; 48: 549–554.
  28. Clinical Assessment Recommendations. 2nd edn. Garner, NC: American Society of Hand Therapists; 1981.
  29. Desrosiers J, Bravo G, Hébert R, Dutil E. Normative data for grip strength of elderly men and women. Am J Occup Ther 1995; 49: 637–644. 
.
  30. Johnson LM, Randall MJ, Reddihough DS, Oke LE, Byrt TA, Bach TM. Development of a clinical assessment of quality of movement for unilateral upper-limb function. Dev Med Child Neurol 1994; 36: 965–973.
  31. Penta M, Tesio L, Arnould C, Zancan A, Thonnard J. The ABILHAND questionnaire as a measure of manual ability in chronic stroke patients. Stroke 2001; 32: 1627–1634.
  32. Kriz G, Hermsdorfer J, Marquardt C, Mai N. Feedback-Based training of grip force control in patients with brain damage. Arch Phys Med Rehabil 1995; 76: 653–659. Link to article
  33. Shrout P, Fleiss JL. Intraclass correlation: uses in assessing rater reliability. Psychol Bull 1979; 86: 420–428. 
. Link to article
  34. Hanten WP, Chen WY, Austin AA, Brooks RE, Carter HC, Law CA, et al. Maximum grip strength in normal subjects from 20 to 64 years of age. J Hand Ther 1999; 12: 193–200.
  35. Peolsson A, Hedlund R, Öberg B. Intra- and inter-tester reliability and reference values for hand strength. J Rehabil Med 2001; 33: 36–41.
  36. Kamimura T, Ikuta Y. Evaluation of grip strength with a sustained maximal isometric contraction for 6 and 10 seconds. J Rehabil Med 2001; 33: 225–229.
  37. Videler AJ, Beelen A, Aufdemkampe G, Groot IJ de, Leemputte M van. Hand strength and fatigue in patients with hereditary motor and sensory neuropathy (types I and II). Arch Phys Med Rehabil 2002; 83: 1274–1278.