OBJECTIVE: To investigate the relation between visual functions, functional vision, and bimanual function in children with unilateral cerebral palsy (uCP).
METHODS: In 49 children with uCP (7-15 y), we investigated the relation between stereoacuity (Titmus Stereo Fly test), visual perception (Test of Visual Perceptual Skills), visuomotor integration (Beery Buktenica Test of Visual-Motor Integration) and functional vision (Flemish cerebral visual impairment questionnaire) with bimanual dexterity (Tyneside Pegboard Test), bimanual coordination (Kinarm exoskeleton robot, Box opening task), and functional hand use (Children\'s Hand-use Experience Questionnaire; Assisting Hand Assessment) using correlations (rs) and elastic-net regularized regressions (d).
RESULTS: Visual perception correlated with bimanual coordination (rs=0.407-0.436) and functional hand use (rs=0.380-0.533). Stereoacuity (rs=-0.404), visual perception (rs=-0.391 to -0.620), and visuomotor integration (rs=-0.377) correlated with bimanual dexterity. Functional vision correlated with functional hand use (rs=-0.441 to -0.458). Visual perception predicted bimanual dexterity (d=0.001-0.315), bimanual coordination (d=0.004-0.176), and functional hand use (d=0.001-0.345), whereas functional vision mainly predicted functional hand use (d=0.001-0.201).
CONCLUSIONS: Visual functions and functional vision are related to bimanual function in children with uCP highlighting the importance of performing extensive visual assessment to better understand children\'s difficulties in performing bimanual tasks.
CONCLUSIONS: Previous findings showed that up to 62 % of children with unilateral cerebral palsy (uCP) present with visual impairment, which can further compromise their motor performance. However, the relation between visual and motor function has hardly been investigated in this population. This study makes a significant contribution to the literature by comprehensively investigating the multi-level relation between the heterogenous spectrum of visual abilities and bimanual function in children with uCP. We found that mainly decreased visual perception was related to decreased bimanual dexterity, bimanual coordination, and functional hand use while impairments in functional vision were only related to decreased functional hand use. Additionally, elastic-net regression models showed that visual assessments can predict bimanual function in children with uCP, however, effect sizes were only tiny to small. With our study, we demonstrated a relation between visual functions and bimanual function in children with uCP. These findings suggest the relevance of thoroughly examining visual functions in children with uCP to identify the presence of visual impairments that may further compromise their bimanual function.
目的:为了研究视觉功能之间的关系,功能视觉,单侧脑瘫(uCP)儿童的双功能。
方法:在49名uCP(7-15岁)儿童中,我们研究了立体敏锐度之间的关系(Titmus立体飞试验),视觉感知(视觉感知技能测试),视觉运动整合(视觉-运动整合的BeeryBuktenica测试)和功能视觉(佛兰德脑视觉障碍问卷),双手灵活性(泰恩赛德Pegboard测试),双手协调(Kinarm外骨骼机器人,开箱任务),以及使用相关性(rs)和弹性网正则化回归(d)的功能性手使用(儿童手使用经验问卷;辅助手评估)。
结果:视觉感知与双手协调(rs=0.407-0.436)和功能性手使用(rs=0.380-0.533)相关。立体灵敏度(rs=-0.404),视觉感知(rs=-0.391至-0.620),和视觉运动积分(rs=-0.377)与双手灵活性相关。功能性视力与功能性手使用相关(rs=-0.441至-0.458)。视觉感知预测双手灵活性(d=0.001-0.315),双配位(d=0.004-0.176),和功能性手使用(d=0.001-0.345),而功能性视力主要预测功能性手的使用(d=0.001-0.201)。
结论:uCP患儿的视觉功能和视觉功能与双手功能相关,强调了进行广泛的视觉评估以更好地了解儿童执行双手任务的困难的重要性。
结论:先前的研究结果表明,高达62%的单侧脑瘫(uCP)儿童存在视力障碍,这可能会进一步损害他们的电机性能。然而,在这个人群中,视觉和运动功能之间的关系几乎没有被研究过。这项研究通过全面调查uCP儿童视觉能力的异质性与双功能之间的多层次关系,为文献做出了重大贡献。我们发现视觉感知下降主要与双手灵活性下降有关,双协调,和功能性手使用,而功能性视力障碍仅与功能性手使用减少有关。此外,弹性网络回归模型表明,视觉评估可以预测uCP儿童的双功能,然而,效果大小只有很小到很小。随着我们的研究,我们证明了uCP儿童的视觉功能与双手功能之间的关系。这些发现表明,彻底检查uCP儿童的视觉功能以确定可能进一步损害其双手功能的视觉障碍的存在。