Arm Muscle Strength in Children with Bilateral Spastic CP

Abstract

Aims

To assess arm-muscle strength related to motor function in children with bilateral spastic cerebral palsy, 5–15 years old.

Methods

Muscle strength was measured for shoulder abductors, elbow extensors and flexors, wrist extensors, and grip strength. The children were grouped according to the Manual Ability Classification Scale (MACS).

Results

Forty-two children were included. The majority of the children at MACS levels I–II were within the normal range; shoulder abductors were weakest (mean 60–80% of predicted value), and variation was greatest for wrist extensors.

Children at MACS level II showed lower values than children at level I, with significant differences for shoulder abductors (p=.028) and wrist extensors (p<.001). Differences between the dominant and non-dominant side was greater in children at MACS level II and statistically significant for wrist extensors (p=.024).

Of 15 children tested for grip strength, nine were within the 2 SD range. The three children at MACS level II, all walking with a walker, had a higher mean value than those at MACS level I.

Conclusions

Muscle strength was lower and differences were greater between sides in children at MACS level II. Wrist extensors showed a decreasing trend with age as compared with normal development.

Keywords:

• Muscle strength
• cerebral palsy
• children
• arm
• hand

Acknowledgements

We would like to express our sincere gratitude to all the children and adolescents as well as their parents who took the time to participate in and contribute to this study.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The study was supported by the Norrbacka-Eugenia foundation.

Notes on contributors

Meta N. Eek

Meta N. Eek is an Associate Professor of physiotherapy at the Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Sweden.

Git Lidman

Git Lidman is a PhD and a registered Occupational Therapist, specialist in Habilitation and Disability Care at the Regional Rehabilitation Centre, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden and a lecturer at the Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Sweden.