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Upper limb performance and the structuring of joint movement in teenagers with cerebral palsy: the reciprocal role of task demands and action capabilities

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Abstract

Individuals with unilateral cerebral palsy (CP) demonstrate reduced performance in upper limb tasks compared to typically developing (TD) peers. We examined whether task conditions modify differences between teenagers with and without CP during a reciprocal aiming task. Twenty teenagers (nine CP and 11 TD) moved a pointer between two targets as fast as possible without missing a target. Task conditions were manipulated by changing the targets’ size, by modifying the inertial properties of the pointer and by varying the upper limb used to perform the task (preferred/non-affected and non-preferred/affected upper limbs). While compared to TD peers, CP teenagers exhibited lower performance (longer movement times). Such differences were attenuated when the task was performed with the preferred upper limb and when accuracy requirements were less stringent. CP teenagers were not differentially affected by the pointer inertia manipulation. Task conditions not only affected performance but also joint kinematics. CP teenagers revealed less movement at the elbow and more movement at the shoulder when performing the task with their less skilled upper limb. However, both CP and TD teenagers demonstrated a larger contribution of trunk movement when facing more challenging task conditions. The overall pattern of results indicated that the joint kinematics employed by individuals with unilateral CP constituted adaptive responses to task requirements. Thus, the explanation of the effects of unilateral CP on upper limb behavior needs to go beyond a context-indifferent manifestation of the brain injury to include the interaction between task demands and action capabilities.

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Acknowledgments

Financial support for this study was granted by the Brazilian government agencies National Council for Scientific and Technological Development (CNPq), Coordination for the Improvement of Higher Level Personnel (CAPES) and by the Research Support Foundation from the State of Minas Gerais (FAPEMIG).

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The authors declare that they have no conflict of interest.

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Correspondence to Marisa Cotta Mancini.

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Figueiredo, P.R.P., Silva, P.L., Avelar, B.S. et al. Upper limb performance and the structuring of joint movement in teenagers with cerebral palsy: the reciprocal role of task demands and action capabilities. Exp Brain Res 233, 1155–1164 (2015). https://doi.org/10.1007/s00221-014-4195-3

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  • DOI: https://doi.org/10.1007/s00221-014-4195-3

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