Objective: For treatment of CP patients multidisciplinary approach is often promoted. But it is not cost-efficient to involve all medical staff and use wide variety of diagnostic and intervention tools for every single patient.

Background: Having knowledge on pivotal manifestations of CP and what are they related to would ease implementation of multidirectional approach in practice. It will shorten a search of pathologies only to those related to main manifestations of the disease and allow to treat main symptoms related to quality of life.

Method: 607 children aged 2 to 18 years (mean age‒6y 4m) with CP (G80): examined by 3 independent doctors. 56%males, 44%females. Randomized blinded assessment. Fine hand function assessed by “9-hole peg” test, “Box and Blocks” test, dynamometry. Intellectual functioning assessment was done using Raven Matrices. Quality of Life(QoL) assessment according to Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). The intraclass correlation coefficient (ICC) was used for finding out discrepancies between observers. Inferencial statistics including 95%CI and P-value. Spearman’s rank correlation coefficient for non-parametric measures of variables.

Results: ICC coefficient between observers was reliable‒0.92 (95%CI:0.89–0.95). The mean QoL score for children GMFCS levels I and II was 58.4 (SD 16.5), for GMFCS III, IV and V children‒22.2 (SD13.4). QoL was more related to fine hand functioning (r=0,344) than to cognition (r=0,292). There was a strong correlation bond between fine hand functioning and cognition (r=0,663). In case fine hand function improved positive changes in cognition were observed in 74% of subjects(p<0,05). Correlation between grasp power and IQ was weak (r=0,184). Also grasp power improvement was slightly related to QoL (r=0,101).

Conclusion: Most important part of the research was the benefit from finding out bond between cognition, hand functioning and quality of life. The quality of life is the most improtant of all and our final aim is QoL improvement to the highest extent possible. Study allowed to understand what is better to work on (hand accuracy but not power) for improvement of cognitive functioning. Positive changes in fine hand functioning improve QoL even more that cognitive changes. So training of fine motor skills should be given a priority in case of limited rehabilitation resources.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/inter-relation-between-hand-functioning-cognition-and-quality-of-life-of-cp-children-2-year-prospective-randomized-study/