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Increased use of the affected hand one and a half years after surgical correction for cerebral palsy and subsequent intensive hand therapy

Introduction Good hand function is essential for carrying out daily activities. People with unilateral cerebral palsy often have spasticity in their affected hand and arm, which makes it difficult to perform bimanual tasks. The aim of this study was to measure changes in grip span, strength and functional use of the affected hand when assisting in two-handed activities after surgical correction for cerebral palsy and subsequent intensive hand therapy. Methods Since 1999, we have been evaluating all patients with unilateral cerebral palsy who had the potential for surgical correction of their forearm and hand, followed by intensive hand therapy at our university hospital. We tested their grip span, strength and use in two-handed activities preoperatively and six and 18 months postoperatively. Results Between 1999 and 2011, 39 patients have had a corrective operation with tendon transfer to correct a deformity of the wrist and most have had a correction of the thumb as well. All received subsequent hand therapy until six months after the operation. Grip span, strength and changes in the functional use of the affected hand when assisting in two-handed activities all increased significantly (p<0.01), six and 18 months postoperatively. Discussion Patients demonstrated a more useful affected hand in everyday activities and results persisted after the rehabilitation ceased at six months. Our findings support surgical correction for cerebral palsy followed by intensive hand therapy improves hand position and hand function.