Hand Function In Patients of Cerebral Palsy: A Prospective Study From Punjab

Abstract

It is found that 10% of the global population has some form of disability from different causes; in India , it is 3.8% of the population. Nearly 15-20% of physically disabled children are affected by Cerebral Palsy. In India, the estimated incidence is around 3/1000 live births. Cerebral palsy is the most common motor disability in childhood. The topographic classification of CP is monoplegia, hemiplegia, diplegia and quadriplegia; monoplegia and triplegia are relatively uncommon. Diplegia is the commonest form at 30%-40%.spastic CP is the commonest and accounts for 70%-75% of all cases. Hand function is affected in cerebral palsy but studied very less and very little data is available on hand function in different cerebral palsy Objectives: To describe aspects of hand function in children with cerebral palsy Methods: This prospective study was conducted on 60 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 60 children of cerebral palsy. Hand function was classified according to the Manual Ability Classification System(MACS) and House functional classification system. Results: In the total population of children with Cerbral palsy aged 5 to 12 years , 81% had more than minor problems with hand function (>MACS 1). We found 23% of the children with MACS 5 with severe limitation of hand function. Only 19% of children were able to handle objects easily and successfully and were classified in MACS1.according to the house functional classification , both the Hands were spontaneously and independently used in 51% of children (house 7-8) , whereas 11% did not use either of their hands(House 0). Conclusion: Hand function limitations are present in all kinds of CP, however the features of the disability range significantly amongst CP subtypes. The MACS classification can be used to assess how well children manage things in everyday situations. The House functional classification depicts grip function in each hand independently.. All of these classifications have been found to be beneficial in a population-based health-care approach, although more research into the psychometric features of these classifications is needed.