The Grasping Deficit in Infantile Spastic Hemiparesis

[摘要] In children with spastic hemiplegia, the arm is usually more incapacitated than the leg. In this paper the author analyzes some of the physiologic principles which aid in the understanding of this important motor deficit.Voluntary grasping in patients with spastic hemiparesis is first apparent in terms of slowness of motor response and also the latent period in initiating the movement. Further deficiencies appear as the action continues; an obvious lack of dexterity and clumsiness occurs as the hand approaches the object to be grasped, the fingers overextending and abducting widely (avoiding-reaction). As the digits close around the object the wrist flexes, often acutely, and if the power of the grip is increased, an associated flexion of elbow and shoulder occur (flexor synergy). These flexion movements associated with grasping serve only to weaken the grip because in the strong normal grasp, the wrist is fixed in some extension and the elbow is fixed by both triceps and biceps. Such careful analysis of a deficient motor mechanism may provide valuable information in the rehabilitation of children with hemiparesis.

[学科分类] 儿科学