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Relative contribution of motor impairments to limitations in activity and restrictions in participation in adults with hemiplegic cerebral palsy

Objective: To determine which motor impairments make a significant relative contribution to upper limb activity limitations, and whether activity limitations are related to participation restrictions in people with hemiplegic cerebral palsy. Design: An observational study. Setting: Neurological Rehabilitation Research Group at Faculty of Health Sciences, The University of Sydney. Subjects: Twenty-three people with hemiplegic cerebral palsy participated. Main measures: Four motor impairments (strength, coordination, spasticity and contracture), upper limb activity and participation were measured. Multiple regression was used to determine the relative contribution of motor impairments to activity limitations. Linear regression was used to determine the correlation between activity and participation. Results: The four motor impairments accounted for 63% of the variance in upper limb activity with coordination independently accounting for 21% (P<0.01). Upper limb activity accounted for 13% of the variance in participation (P=0.10). Conclusions: The findings imply that coordination of four motor impairments makes the largest independent relative contribution to activity limitations, whereas upper limb activity makes less contribution to participation in people with mild and moderate hemiplegic cerebral palsy.