Yonsei Med J.  2020 Mar;61(3):235-242. 10.3349/ymj.2020.61.3.235.

Contra-Lateral Unintended Upper Arm Movement during Unimanual Tasks in Children with Cerebral Palsy

• Kim SK
• Park HK
• Park ES

• KMID: 2470920
• DOI: http://doi.org/10.3349/ymj.2020.61.3.235

Abstract

PURPOSE
To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks and to identify factors related to ARs in children with cerebral palsy (CP).
MATERIALS AND METHODS
This was a prospective, cross-sectional study of 35 children with CP. The extent of ARs of the contra-lateral, non-task hand was assessed while performing three unimanual tasks (opening and clenching the fist, a finger opposition task, and tapping fingers). The occurrence of ARs in each trial was evaluated separately for each task using a four-point scale (total scores ranged from 0 to 12). Surface electromyography (SEMG) was used to measure the firing activity of the muscles of the opposite arm during the task. The Manual Ability Classification System and Melbourne Assessment 2 (MA-2) were used to evaluate upper limb function.
RESULTS
AR scores were higher in the more-affected limb than in the less-affected limb. SEMG data on the non-task hand showed motor overflow up to the elbow muscles in the more-affected limb. Root mean square ratios of EMG signals were significantly higher in children with ARs than in children without ARs. Multiple regression analysis showed both age and MA-2 to be significant factors related to ARs in the more-affected limb.
CONCLUSION
Children with visible ARs showed motor overflow in the non-task limb during unimanual hand tasks. Age and upper limb function were significantly related to the extent of ARs in the more-affected limb of children with CP.

Keyword

Cerebral palsy; associated reaction; upper limb function

MeSH Terms

Arm*
Cerebral Palsy*
Child*
Classification
Cross-Sectional Studies
Elbow
Electromyography
Extremities
Fingers
Fires
Hand
Humans
Muscles
Prospective Studies
Upper Extremity

Figure

• 

  Fig. 1 Muscle activity of the upper limb on surface EMG during rest and five trials of Task 1 with the opposite hand in two children with unilateral CP. (A) Visible AR (+): muscle activities of the elbow extensor, wrist flexor, and wrist extensor in the more-affected side increased during tasks with the less-affected hand, compared to baseline activities at rest. (B) Visible AR (−): muscle activities of the upper limb in the less-affected side during tasks with the more-affected hand did not increase, compared to baseline activities at rest. CP, cerebral palsy; AR, associated reaction.

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