Background

Children and adolescents with cerebral palsy demonstrate impairments in grip control with associated limitations in functional grasp. Previous work in cerebral palsy has focused on grip control using relatively predictable task demands, a feature which may limit generalizability of those study results in light of recent evidence in typically developing adults suggesting that grip control strategies are task-dependent. The purpose of this study was to determine whether and how varying upper extremity task demands affect grip control in children and adolescents with cerebral palsy.

Methods

Children and adolescents with mild spastic cerebral palsy (n = 10) and age- and gender-matched typically developing controls (n = 10) participated. Participants grasped an object while immersed in a virtual environment displaying a moving target and a virtual representation of the held object. Participants aimed to track the target by maintaining the position of the virtual object within the target as it moved in predictable and unpredictable trajectories.

Findings

Grip control in children with cerebral palsy was less efficient and less responsive to object load force than in typically developing children, but only in the predictable trajectory condition. Both groups of participants demonstrated more responsive grip control in the unpredictable compared to the predictable trajectory condition.

Interpretation

Grip control impairments in children with cerebral palsy are task-dependent. Children and adolescents with cerebral palsy demonstrated commonly observed grip impairments in the predictable trajectory condition. Unpredictable task demands, however, appeared to attenuate impairments and, thus, could be exploited in the design of therapeutic interventions.

中文翻译：

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脑性瘫痪的儿童和青少年可以灵活地控制抓地力，以应对各种任务需求。

背景

患有脑瘫的儿童和青少年表现出抓地力控制受损，并伴有功能性抓地力的局限性。先前在脑瘫方面的工作主要集中在使用相对可预测的任务需求进行抓地力控制方面，鉴于典型的成年成年人的最新证据表明，抓地力控制策略依赖于任务，这一特征可能会限制那些研究结果的推广性。这项研究的目的是确定上肢任务需求的变化是否以及如何影响对脑瘫儿童和青少年的抓地力控制。

方法

患有轻度痉挛性脑瘫（n =  10）且年龄和性别相匹配的典型发育对照（n =  10）的儿童和青少年参加。参与者沉浸在虚拟环境中抓握物体，该虚拟环境显示了移动的目标和所持物体的虚拟表示。参与者旨在通过在目标可预测和不可预测的轨迹中移动虚拟对象时保持其在目标内的位置来跟踪目标。

发现

与典型发育中的儿童相比，脑瘫儿童的握力控制效率较低，对物体负荷力的反应较差，但仅在可预测的运动状态下有效。与可预测的轨迹状态相比，两组参与者在不可预测的情况下均表现出更灵敏的抓地力控制。

解释

脑瘫患儿的握力控制障碍取决于任务。脑瘫儿童和青少年在可预测的轨迹状态下表现出普遍观察到的抓地力障碍。但是，不可预测的任务需求似乎减轻了损伤，因此可以在治疗干预措施的设计中加以利用。