Daily Living Activities in Young Adults With Cerebral Palsy

Completed

• Conditions: Cerebral Palsy; Sensitivity; Motor Skills Disorders; Activity, Motor

• Registration Number: NCT06909994
• Lead Sponsor: Universidad de Burgos

Brief Summary

This study explored the relationship between sensory function and occupational performance in young adults with Cerebral Palsy. Using standardized assessments, researchers compared tactile sensitivity and discrimination between individuals with CP and neurotypical controls, and examined how these sensory variables relate to motor function, ADLs, and IADLs.

Detailed Description

Background: Sensory impairments are increasingly recognized as influential factors in the occupational performance of individuals with Cerebral Palsy (CP). Although prior studies have explored this relationship in children, evidence in young adults remains limited.

Objective: This study aimed to compare tactile sensitivity and discrimination in young adults with CP and neurotypical individuals, and to examine their association with motor-related variables relevant to occupational performance: muscle tone, grip strength, manual dexterity, Activities of Daily Living (ADLs), and Instrumental Activities of Daily Living (IADLs).

Methods: A multicenter cross-sectional study was conducted involving two groups of 36 participants aged 16-45 years. Sensory and motor variables were assessed using the Semmes-Weinstein Monofilaments, Two-Point Discrimination Test, Modified Ashworth Scale, Digital Dynamometer, Box and Block Test, Functional Independence Measure, and the Lawton and Brody Scale.

Conclusion: Findings highlight the relevance of sensory function in the occupational performance of young adults with CP. These results underscore the need for occupational therapy interventions that integrate sensory assessments and target sensory-motor integration to improve functional independence and participation.

Study Timeline

• Status Verified: 2025-03
• Study Start: 2025-03-07
• Primary Completion: 2025-03-20
• Study Completion: 2025-03-26
• Study First Submitted: 2025-03-26
• Study First Submitted QC: 2025-04-02
• Last Update Submitted: 2025-04-02
• Study First Posted: 2025-04-04
• Last Update Posted: 2025-04-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 36

Inclusion Criteria

• young people and adults with a medical diagnosis of CP, who had a motor condition of hemiparesis, diparesis, or tetraparesis;
• aged between 16 and 45 years
• had a minimum score of 19 on the Mini Mental State Examination cognitive assessment scale
• authorized their participation in the study by signing an informed consent form. In cases between the ages of 16 and 18 years, informed consent was signed by the participants and their parents or legal guardians

Exclusion Criteria

• any peripheral nerve injury
• shoulder, elbow, wrist or hand injuries
• individuals whose mother tongue was neither Portuguese nor Spanish

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Semmes-Weinstein monofilaments	1 month	This non-invasive technique assesses cutaneous sensory perception using nylon monofilaments of varying diameters that apply specific pressure forces. These forces range from 0.07 g (smallest) to 300 g (largest). In this study, monofilaments were applied to distinct areas innervated by different nerves: the distal phalanx of the first, second, and third fingers and the thenar eminence (median nerve), the fifth finger and hypothenar eminence (ulnar nerve), and the proximal phalanx of the first and second fingers on the dorsal side (radial nerve).
Two-point discrimination test	1 month	This test evaluates the ability to distinguish between two closely spaced pressure points on the skin, reflecting sensory acuity and receptor density. Distances typically range from 0 to 8 mm. Despite being widely used, standardization of pressure remains a challenge; a light, uniform pressure (10-15 g) is recommended. In this study, the same hand regions assessed with monofilaments were used. Proper simultaneous application was ensured to avoid perception bias.
Modified Ashworth Scale (MAS)	1 month	The MAS is widely used to evaluate muscle spasticity by measuring resistance to passive movement. The scale ranges from 0 (no tone increase) to 4 (severe rigidity), with the inclusion of score 1+ for greater sensitivity. In this study, assessments were performed on elbow and wrist flexor/extensor muscles, muscles involved in pronation/supination, and finger flexors/extensors. The scale helps quantify the degree of hypertonia, a common symptom in individuals with neurological conditions.
Digital dynamometer	1 month	Grip strength was measured using a handheld digital dynamometer, which quantifies isometric force output in kilograms. Testing was conducted with participants seated, shoulder adducted, elbow at 90º, forearm in neutral, and wrist extended 0º-30º. Both upper limbs were assessed. This measurement reflects overall upper limb strength and functional capacity, and is considered a reliable indicator of motor performance in clinical populations.
Box and Block Test	1 month	This test evaluates unilateral manual dexterity by counting the number of wooden blocks a participant can transfer from one side of a partitioned box to the other within 60 seconds. A 15-second practice trial was included to ensure familiarity with the procedure. It is a validated tool for individuals with neurological impairments and provides a quick, functional measure of hand coordination. Performance was assessed for both dominant and non-dominant hands.
Functional Independence Measure	1 month	The FIM assesses performance in Activities of Daily Living (ADLs) across two domains: motor (13 items) and cognitive/social (5 items). Each item is rated on a 7-point scale from total dependence (1) to complete independence (7), with a maximum total score of 126. It evaluates self-care, sphincter control, mobility, communication, and social cognition. This tool is widely used to determine the level of assistance required in daily life
Lawton and Brody Scale	1 month	This scale measures independence in Instrumental Activities of Daily Living (IADLs), such as using the telephone, managing medications and finances, shopping, cooking, and transportation. Scores range from 0 (dependent in all tasks) to 8 (independent in all tasks). It is particularly useful for evaluating more complex, community-based activities that are essential for independent living and is a standard tool in occupational therapy and geriatric assessment

Trial Locations

Locations (1)

Olalla Saiz Vazquez; 🇪🇸 Burgos, Spain