Abstract
Background and aims: The term ‘hemiplegia’ implies a unilateral deficit, yet several studies have demonstrated abnormal limb control ipsilateral to the brain lesion. This is under-recognised by clinicians and has implications for function and therapy. We documented deficits in the “unaffected” hand in children with hemiplegia using a dexterity test developed by our group for use in children with motor disorders.
Methods: Participants: 33 children (4-11y) with hemiplegia (18 male; 19 left hemiplegia); 66 age, sex and handedness matched controls. Assessment: Adapted 9-hole pegboard test (2 adjacent boards; 3 peg sizes; electronically timed). Analysis: ANOVA (between-group factors group (hemiplegia/control), age (4-5, 6-7, 8-11), sex, dominant hand) performed separately for each peg size.
Results: Some hemiplegic children with radiologically confirmed unilateral lesions had prolonged pegboard completion times whereas others scored similarly to controls (Figure: filled symbols - hemiplegia). For all peg sizes, main effects of group (p< 0.001) and age (p< 0.001) were significant but sex and dominant hand were not. There was a significant interaction between group and age (p< 0.005), with smaller difference in group means in the oldest age-group. This deserves exploration with a longitudinal study.
Conclusion: The “unaffected” hand in children with hemiplegia is less dextrous than the dominant hand of controls. Therapy to improve function of the more-affected hand should be designed to achieve optimal outcomes bilaterally.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Basu, A., Pearse, J., Kirkpatrick, E. et al. Raising Awareness of the Myth of the “Unaffected Hand” in Childhood Hemiplegia. Pediatr Res 70 (Suppl 5), 152 (2011). https://doi.org/10.1038/pr.2011.377
Issue Date:
DOI: https://doi.org/10.1038/pr.2011.377