Background

Childhood arterial ischemic stroke (AIS) is associated with significant morbidity with up to 50% of affected children developing hemiparesis. Hemiparesis is assumed to influence participation within the peer group, but it is unclear to what extent its severity affects participation in different areas of social life.

Methods

Thirteen children (mean age 9y6m) with AIS (6 without hemiparesis, 7 with hemiparesis) and 21 controls (mean age 9y8m) participated. We scored hemiparesis severity with hand strength asymmetry (pinch and grip strength), measured with a dynamometer. We assessed manual ability (ABILHAND-Kids), socioeconomic status (Family Affluence Scale) and participation (Participation and Environment Measure – Children and Youth). From structural MRI, we measured lesion size. We investigated differences in participation and its relationship with hemiparesis severity using non-parametric partial correlations (controlling for lesion size, manual ability, and socioeconomic status), interpreted as absent (r < 0.25), weak (r = 0.25–0.50), moderate (r = 0.50–0.75) or strong (r > 0.75). Analyses were performed in jamovi 1.6.3.

Results

Children with AIS (with or without hemiparesis) showed reduced participation frequency at school (p < 0.001), whilst participation at home and in the community resembled that of their peers. Severity of hemiparesis was moderately related to frequency and involvement at home and to involvement and desire for change in the community, although unrelated to school participation.

Conclusion

Reduced participation in school life requires close attention in the follow-up of children with AIS - regardless of the severity of hemiparesis. Participation at home and in the community is related to hemiparesis severity and may be improved with participation-focused motor intervention strategies.

中文翻译：

---

儿童卒中后参与：与病灶大小、运动功能和手动能力有关系吗？

背景

儿童动脉缺血性中风 (AIS) 与显着的发病率相关，多达 50% 的受影响儿童会出现偏瘫。假设偏瘫会影响同龄人群体的参与，但尚不清楚其严重程度对不同社会生活领域的参与有何影响。

方法

13 名患有 AIS 的儿童（平均年龄 9 岁 6 米）（6 名没有偏瘫，7 名有偏瘫）和 21 名对照组（平均年龄 9 岁 8 米）参与了试验。我们用测力计测量手部力量不对称（捏和握力）对偏瘫严重程度进行评分。我们评估了手工能力（ABILHAND-Kids）、社会经济地位（家庭富裕量表）和参与（参与和环境测量——儿童和青年）。从结构 MRI 中，我们测量了病灶大小。我们使用非参数偏相关（控制病灶大小、手动能力和社会经济地位）调查了参与的差异及其与偏瘫严重程度的关系，解释为缺席 (r < 0.25)、弱 (r = 0.25–0.50)、中度(r = 0.50–0.75) 或强 (r > 0.75)。在jamovi 1.6.3 中进行分析。

结果

患有 AIS 的儿童（有或没有轻偏瘫）在学校的参与频率降低（p < 0.001），而在家和社区的参与与同龄人相似。偏瘫的严重程度与在家的频率和参与度以及社区的参与度和对改变的渴望有中等程度的相关性，尽管与学校参与度无关。

结论

减少对学校生活的参与需要密切关注 AIS 儿童的随访 - 无论偏瘫的严重程度如何。家庭和社区的参与与轻偏瘫的严重程度有关，可以通过以参与为中心的运动干预策略得到改善。