The Relationship Between the Damages of Hand Functions and the Type of Cerebral Palsy in Children

Objective To establish correlations between joint proprioception, muscle flexion and extension peak torque, and functional ability in patients with knee osteoarthritis （OA）. Methods Fifty-six patients with symptomatic knee OA were recruited in this study. Both proprioceptive acuity and muscle strength were measured using the isomed-2000 isokinetic dynamometer. Proprioceptive acuity was evaluated by establishing the joint motion detection threshold (JMDT). Muscle strength was evaluated by Max torque （Nm） and Max torque/weight （Nm/kg）. Functional ability was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlational analyses were performed between proprioception, muscle strength, and functional ability. A multiple stepwise regression model was established, with WOMAC-PF as dependent variable and patient age, body mass index (BMI), visual analogue scale (VAS)-score, mean grade for Kellgren-Lawrance of both knees, mean strength for quadriceps and hamstring muscles of both knees, and mean JMDT of both knees as independent variables. Results Poor proprioception (high JMDT) was negatively correlated with muscle strength ( P<0.05). There was no significant correlation between knee proprioception （high JMDT） and joint pain （WOMAC pain score）, and between knee proprioception （high JMDT） and joint stiffness （WOMAC stiffness score）. Poor proprioception (high JMDT) was correlated with limitation in functional ability (WOMAC physical function score r=0.659, P<0.05). WOMAC score was correlated with poor muscle strength (quadriceps muscle strength r=－0.511, P<0.05, hamstring muscle strength r=－0.408, P<0.05). The multiple stepwise regression model showed that high JMDT 〔standard partial regression coefficient (B)=0.385, P<0.05〕 and high VAS-scale score (B=0.347, P<0.05) were significant predictors of WOMAC-PF score. Conclusion Patients with poor proprioception is associated with poor muscle strength and limitation in functional ability. Patients with symptomatic OA of knees commonly endure with moderate to considerable dysfunction, which is associated with poor proprioception (high JMDT) and high VAS-scale score.