Evaluation of Hand function in patients of Cerebral Palsy: A prospective study from North India

Abstract

Introduction: It has been shown that 10% of the global population suffers from some sort of disability due to various reasons; in India, this figure is 3.8 percent of the population. Cerebral Palsy affects approximately 15-20% of physically challenged children. In India, the incidence is estimated to be around 3/1000 live births. The most prevalent motor disability in children is cerebral palsy. Monoplegia, hemiplegia, diplegia, and quadriplegia are the topographic classifications for CP; monoplegia and triplegia are relatively uncommon. Diplegia is the most prevalent type, accounting for 30 percent to 40 percent of all cases. The most prevalent type of CP is spastic CP, which accounts for 70 percent to 75 percent of all cases. Cerebral palsy affects hand function, however it has been studied very rarely and there is very little data on hand function in different types of cerebral palsy. Objectives: To describe characteristics of hand function in cerebral palsy children. Methods: This prospective study was conducted on 100 children of cerebral palsy who came to the department of Physical Medicine and Rehabilitation, Government medical college patiala from Aug 2021 to Oct 2021. Upper extremity data were collected from the 100 children of cerebral palsy. Hand function was classified according to the Manual Ability Classification System(MACS) and House functional classification system. Results: In the overall group of Cerebral Palsy children aged >5 to <14 years, 81 percent reported more than modest hand function deficits (>MACS 1). We discovered that 23% of children with MACS 5 had substantial limitations in hand function. Only 19% of children were classed as MACS1 because they were unable to handle objects effortlessly and successfully. According to the house functional classification, 46 percent of children (house 7-8) used both hands spontaneously and independently, while 7 percent did not use either hand (House 0) Conclusion: Hand function deficits are evident in all types of CP, however the characteristics of the disability differ greatly. The MACS classification can be used to determine how well children handle situations in everyday life. The grip function in each hand is depicted separately in the House functional classification. Although additional research into the psychometric aspects of these classifications is needed, they have all been demonstrated to be effective in a population-based health-care strategy.