Relationships between activities of daily living, upper limb function, and visual perception in children and adolescents with unilateral cerebral palsy

AimThis study examined relationships between activities of daily living (ADL) motor and process skills, unimanual capacity, bimanual performance, and visual perception in children with unilateral cerebral palsy (CP). MethodParticipants were 101 children with unilateral CP (51 males, 50 females; mean age 11y 9mo [SD 2y 5mo; range 8-17y]; Manual Ability Classification System [MACS] level I=24; level II=76; level III=1). Measures were (1) Assessment of Motor and Process Skills (AMPS), (2) Jebsen-Taylor Test of Hand Function (JTTHF), (3) Assisting Hand Assessment (AHA), and (4) Test of Visual Perceptual Skills, 3rd edition (TVPS-3). Regression models were constructed with the AMPS motor scale and AMPS process as the dependent variables. ResultsThe AHA and JTTHF dominant upper limb score together explained 57% of the variance in AMPS motor scale scores. TVPS-3 Visual Sequential Memory, TVPS-3 Visual Closure, and JTTHF dominant upper limb score together explained 35% of the variance in AMPS process scale scores. InterpretationBimanual performance and unimanual capacity of the dominant upper limb are significantly associated with ADL motor skills in children with unilateral CP. Process skills of ADL are related to visual perceptual ability and dominant upper limb unimanual capacity, which may reflect motor planning required to perform daily tasks. What this paper adds Bimanual performance and unimanual capacity of the dominant upper limb are associated with activities of daily living (ADL) motor skills in children with unilateral cerebral palsy. Visual perception ability, most significantly sequential memory and visual closure, are associated with ADL process skills. There is 65% variance in the current model for ADL process skills which is not explained by visual perception and dominant upper limb capacity.