This study examined the relationship between upper limb deformities and functional ability in 139 children with spastic cerebral palsy between the ages of 2-18. The most common deformities were wrist flexion and forearm pronation, which were found to greatly impair functional level as measured by the Jebsen and MACS questionnaires. Results showed that upper limb deformities were a major factor in reducing functional ability. The study concluded that wrist flexion and forearm pronation deformities commonly found in spastic cerebral palsy significantly impair functional level.

1. Department of
Computer Engineering
Group Members:
Supervisor:
1. Abstract
OBJECTIVE: The study was designed to determine the prevalence of upper limb deformities
on functional level of Spastic cerebral Palsy. This study was conducted in the Department of
Children’s Hospital and PSRD, LHR.
METHODS: Cross-sectional study design was used. Sample of 139 patients was taken with
CP who lie in age range of 2-18 years, from which 82 (58.99%) were males and 57 (40.1%)
were females. Structured Performa, Jebson and MACS questionnaire were used for data
collection.
Out of 139 participants, 97 were affected by Spastic CP (69%) and had poor thumb
opposition, 12 participants were affected by Flaccid CP (8.6%) with poor thumb opposition, 5
participants were affected by Dyskinetic CP (3.6%) and most of the participants had both
good active grasp (key pinch only) & mass grasp but poor active control, 22 were affected by
Ataxic CP (15,8%) having good active grasp (key pinch only) & 3 participants were affected
by Mixed CP (2.2%) with no active function in entire upper extremity.
Upper limb deformities in spastic CP were Shoulder internal rotation deformity (2.2%), Elbow
flexion deformity (7.9%), Forearm pronation deformity (18.7%), Wrist flexion deformity (20.1),
Wrist ulnar deviation deformity (13.7%), Thumb in palm deformity (5.8%), Finger flexion
deformity (1.4%) and Finger swan neck deformity (0.0%). Results showed that the upper
limb deformities were the major factor for impairments of functional ability in Spastic
Cerebral Palsy.
Most common upper limb deformities were Wrist flexion deformity & Forearm pronation
deformity which greatly impair the functional level of Spastic Cerebral Palsy. In children
with Spastic CP, functional level was greatly impaired due to upper limb deformities.
Key words:
Spastic cerebral palsy, Upper Limb deformities and Functional level.
Introduction
Cerebral palsy (CP) is a neurological, non-progressive disorder that affects the central
nervous system.
Spastic cerebral palsy is the most common type of CP.
Upper limb deformities greatly affect the functional level of Spastic CP.
Self help skills like bathing, grooming, eating and dressing etc are significantly impaired
MATERIAL ANDMETHODOLOGY
Study Design: Cross-sectional Study
Study Population: CP children from age 2-18 years
Data Collection Instrument: Structured Performa. (MACS & Jebsen).
Sample Size: Sample size calculated via epitool: 139 CP children (Makki et al., 2014).
Abeera
Prevalence of upper limb deformities on
functional level of spastic cerebral palsy
Individuals with mental illness assessed through MOCA (Montreal Cognitive Assessment
Scoring <25).
Data collection procedure: All the patients fulfilling the inclusion criteria were evaluated
and baseline data was recorded. After taking permission from authority. I approached
patient’s caregivers and collected data through Questionnaire which were distributed by
manual method with prior consent of participants & caregivers. The Manual Ability
Classification System (MACS) was used for bimanual performance and Jebsen test for
upper extremity functional patterns.
Data Analysis Procedure: Appropriate Statistical data analysis techniques were applied
by using “SPSS” (Statistical Package for the Social Sciences) version 20. Descriptive
statistical analysis was applied to find out the frequency and percentages of the data while
Chi-Square test was used to assess the prevalence of the data.
Results
Results of my study were significant as p<0.05 as depicted by Chi-square test. The most
common upper limb deformities in spastic cp were Wrist flexion deformity (20.1%) &
Forearm pronation deformity (18.7%).
Age of the participants Gender of participants
Chi-Square test for Jebsen
Chi-Square test for MACS
CONCLUSION
In the present study it was observed that upper limb deformities are the major factor of impairments
of functional ability in Spastic Cerebral Palsy. Most common upper limb deformities in spastic cerebral
palsy were Wrist flexion deformity (20.1%) & Forearm pronation deformity (13.7%) which greatly
impair the functional level of Spastic Cerebral Palsy.
Dr. Aysha
Presented by: Supervisor
Inclusion Criteria
Individuals with age range from 2 to 18 years.
Individuals affected with CP, having upper limb deformities.
Individuals with ability to give informed consent.
Exclusion criteria
Individuals with age less than 2 years and more than 18 years were excluded.
Individuals with systemic issues other than Cerebral palsy.