Upper Extremity Sensation and Impact on Functional Use in Daily Activities in Children With Cerebral Palsy: A Comparison With Typically Developing Peer

Vibration Sense

时间窗: through study completion, an average of 1 year

To assess the vibration sensation of the children included in the study, a 128 Hz tuning fork (Baseline® Tuning Fork, New York, USA) will be used. In this study, participants will be seated on a table with their hips and knees at a 90-degree angle. The tuning fork will then be vibrated by tapping it against the edge of the table, and to ensure the individual feels the vibration, it will first touch their chin. The patient will then be asked to close their eyes, the tuning fork will be vibrated again by tapping it against the edge of the table, and then it will touch the dorsal part of the 1st metacarpal bone. Simultaneously, a stopwatch will be started, and the patient will be asked to state when the vibration stops, and the time will be recorded. The same procedure will be performed first on the non-dominant side and then on the dominant side. The test will be repeated 3 times, and the average of the recorded values will be taken.

stereognosis

时间窗: through study completion, an average of 1 year

In this study, individuals' stereognosia will be assessed by placing three familiar objects (key, spoon, clothespin) and three similar matching objects (e.g., button, safety pin, pencil) in their hands. Participants will be given the objects and asked to identify them with their eyes closed. The object will remain in the participant's hand for a maximum of 30 seconds. They will receive scores ranging from 0 to 6, first for the dominant side and then for the non-dominant side.

Tactile Sense

时间窗: through study completion, an average of 1 year

The Semmes-Weinstein monofilament hand kit (Fei-USA) will be used to assess individuals' tactile sensation. The test will begin with the thinnest monofilament, where the normal pressure should be felt, and progress to darker monofilaments where pressure increases. A trial test will be conducted once with eyes open and closed before the assessment to familiarize each child with the test. The monofilament will be held perpendicular to the skin and pressed against the skin until it slightly bulges. The pressure will be held for 1.5 seconds. The child will be asked if they felt the touch. Assessments will be made on the fingertips and the center of the palm.

Two-Point Discrimination

时间窗: through study completion, an average of 1 year

This study will use a discriminator (Baseline® Discrim-A-Gon 2-Point Discriminator, Fei-USA) to assess individuals' two-point discrimination sense. Individuals will be asked to close their eyes, and the discriminator will be tested by moving it over the pulp of their index finger. The assessment will begin at the maximum distance and gradually decrease until the individual can no longer distinguish between the two points. If the individual perceives the two points as one in two out of three trials, the distance will be noted in millimeters. Light pressure will be applied simultaneously to both ends of the discriminator to ensure as even pressure as possible.

Joint position sense

时间窗: through study completion, an average of 1 year

Joint position sense will be assessed using the Angulus (DPP, USA) test. With eyes closed, the participant's wrist will be passively extended to approximately 30 degrees and held for 10 seconds. Then, the wrist will be returned to the starting (neutral) position, and the participant will be asked to actively return their own wrist to the same position. This process will be repeated three times for each side. The positions achieved by the participant will be measured, and the angle difference between the passive-target position and the active-repositioning will be recorded. The difference between the target angle and the angle produced by the individual will be determined as the error score. Three measurements will be taken, and the average of the differences will be used for analysis. A 30-second rest period will be given between each trial.

Jebsen-Taylor Hand Function Test

时间窗: through study completion, an average of 1 year

The Jebsen-Taylor Hand Function Test (JTHFT) is a standardized and objective test of fine and gross motor hand function using tasks that mimic activities of daily living (ADL). The test consists of seven subtests performed with both dominant and non-dominant hands: writing, card flipping, picking up and placing small objects, stacking checkers, simulated feeding, carrying light objects, and carrying heavy objects. During the assessment, children will be seated in a chair with back support, with their feet flat on the floor. The writing subtest will not be administered as some children may not be at an age to learn to read and write. Each hand will be tested separately. Before each test item, the patient will be shown how to perform the task, instructed to perform the same activity first with one hand and then with the other. For each subtest, the patient will begin with the command "start," and the timer will stop at the end. The time taken to complete each subtest will be recorded.

Abilhand Kids

时间窗: through study completion, an average of 1 year

The Abilhand Kids questionnaire will be used to assess a child's hand dexterity, defined as their ability to manage daily activities requiring the use of the upper extremities, regardless of the strategies involved. Abilhand-Kids is a scale that can be used to assess hand dexterity in children with cerebral palsy (CP). It contains 21 sub-items. The sub-items are scored from 0; cannot, 1; has difficulty, and 2; can easily. The questions are usually answered by the parent, but the child can also answer them if they are old enough and have the appropriate cognitive level.