Daily Living Activities in Young Adults With Cerebral Palsy

Universidad de Burgos36 enrolled

Overview

This study explored the relationship between sensory function and occupational performance in young adults with Cerebral Palsy. Using standardized assessments, researchers compared tactile sensitivity and discrimination between individuals with CP and neurotypical controls, and examined how these sensory variables relate to motor function, ADLs, and IADLs.

Background: Sensory impairments are increasingly recognized as influential factors in the occupational performance of individuals with Cerebral Palsy (CP). Although prior studies have explored this relationship in children, evidence in young adults remains limited. Objective: This study aimed to compare tactile sensitivity and discrimination in young adults with CP and neurotypical individuals, and to examine their association with motor-related variables relevant to occupational performance: muscle tone, grip strength, manual dexterity, Activities of Daily Living (ADLs), and Instrumental Activities of Daily Living (IADLs). Methods: A multicenter cross-sectional study was conducted involving two groups of 36 participants aged 16-45 years. Sensory and motor variables were assessed using the Semmes-Weinstein Monofilaments, Two-Point Discrimination Test, Modified Ashworth Scale, Digital Dynamometer, Box and Block Test, Functional Independence Measure, and the Lawton and Brody Scale. Conclusion: Findings highlight the relevance of sensory function in the occupational performance of young adults with CP. These results underscore the need for occupational therapy interventions that integrate sensory assessments and target sensory-motor integration to improve functional independence and participation.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Cerebral Palsy Sensitivity Motor Skills Disorders Activity, Motor

Interventions

individual assessmentsOTHER

Participants in the CP group underwent individual assessments using seven standardized instruments to evaluate sensory and motor function, as well as independence in daily activities. Data collection was conducted in person at the participating institutions by trained professionals following a structured protocol. All procedures were performed after verifying cognitive eligibility (score ≥ 19) and obtaining informed consent. The same protocol was applied across both centers to ensure consistency. The control group followed the same assessment process. Each evaluation session lasted approximately two hours per participant.

Eligibility

Sex: ALLMin age: 16 YearsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * young people and adults with a medical diagnosis of CP, who had a motor condition of hemiparesis, diparesis, or tetraparesis; * aged between 16 and 45 years * had a minimum score of 19 on the Mini Mental State Examination cognitive assessment scale * authorized their participation in the study by signing an informed consent form. In cases between the ages of 16 and 18 years, informed consent was signed by the participants and their parents or legal guardians Exclusion Criteria: * any peripheral nerve injury * shoulder, elbow, wrist or hand injuries * individuals whose mother tongue was neither Portuguese nor Spanish

Locations (1)

Olalla Saiz Vazquez

Burgos, Burgos, Spain

Outcomes

Primary Outcomes

Semmes-Weinstein monofilaments

This non-invasive technique assesses cutaneous sensory perception using nylon monofilaments of varying diameters that apply specific pressure forces. These forces range from 0.07 g (smallest) to 300 g (largest). In this study, monofilaments were applied to distinct areas innervated by different nerves: the distal phalanx of the first, second, and third fingers and the thenar eminence (median nerve), the fifth finger and hypothenar eminence (ulnar nerve), and the proximal phalanx of the first and second fingers on the dorsal side (radial nerve).

Time frame: 1 month

Two-point discrimination test

This test evaluates the ability to distinguish between two closely spaced pressure points on the skin, reflecting sensory acuity and receptor density. Distances typically range from 0 to 8 mm. Despite being widely used, standardization of pressure remains a challenge; a light, uniform pressure (10-15 g) is recommended. In this study, the same hand regions assessed with monofilaments were used. Proper simultaneous application was ensured to avoid perception bias.

Time frame: 1 month

Modified Ashworth Scale (MAS)

The MAS is widely used to evaluate muscle spasticity by measuring resistance to passive movement. The scale ranges from 0 (no tone increase) to 4 (severe rigidity), with the inclusion of score 1+ for greater sensitivity. In this study, assessments were performed on elbow and wrist flexor/extensor muscles, muscles involved in pronation/supination, and finger flexors/extensors. The scale helps quantify the degree of hypertonia, a common symptom in individuals with neurological conditions.

Time frame: 1 month

Digital dynamometer

Grip strength was measured using a handheld digital dynamometer, which quantifies isometric force output in kilograms. Testing was conducted with participants seated, shoulder adducted, elbow at 90º, forearm in neutral, and wrist extended 0º-30º. Both upper limbs were assessed. This measurement reflects overall upper limb strength and functional capacity, and is considered a reliable indicator of motor performance in clinical populations.

Data from ClinicalTrials.gov

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