@article{ludovice_saul_kamper_2024, title={Use of computational modeling to examine fingertip force production in children with hemiplegic cerebral palsy}, volume={172}, ISSN={["1873-2380"]}, DOI={10.1016/j.jbiomech.2024.112198}, abstractNote={Most children with hemiplegic cerebral palsy (HCP), one of the most prevalent subtypes of cerebral palsy, struggle with grasping and manipulating objects. This impairment may arise from a diminished capacity to properly direct forces created with the finger pad due to aberrant force application. Children with HCP were asked to create maximal force with the index finger pad in the palmar (normal) direction with both the paretic and non-paretic hands. The resulting forces and finger postures were then applied to a computational musculoskeletal model of the hand to estimate the corresponding muscle activation patterns. Subjects tended to create greater shear force relative to normal force with the paretic hand (p < 0.05). The resultant force was directed 33.6°±10.8° away from the instructed palmar direction in the paretic hand, but only 8.0°±7.3° in the non-paretic hand. Additionally, participants created greater palmar force with the non-paretic hand than with the paretic hand (p < 0.05). These differences in force production are likely due to differences in muscle activation pattern, as our computational models showed differences in which muscles are active and their relative activations when recreating the measured force vectors for the two hands (p < 0.01). The models predicted reduced activation in the extrinsic and, especially, the intrinsic finger muscles, potentially due to reduced voluntary activation or muscle atrophy. As the large shear forces could lead to objects slipping from grasp, creation and modulation of the appropriate muscle activation patterns may provide an important target for therapeutic treatment in children with HCP.}, journal={JOURNAL OF BIOMECHANICS}, author={Ludovice, Miranda C. and Saul, Katherine R. and Kamper, Derek G.}, year={2024}, month={Jul} }
 @misc{mccall_ludovice_elliott_kamper_2022, title={Hand function development of children with hemiplegic cerebral palsy: A scoping review}, volume={15}, ISSN={["1875-8894"]}, DOI={10.3233/PRM-200714}, abstractNote={PURPOSE: Hemiplegic cerebral palsy (hCP) typically impacts sensorimotor control of the hand, but comprehensive assessments of the hands of children with hCP are relatively rare. This scoping review summarizes the development of hand function for children with hCP. METHODS: This scoping review focused on the development of hand function in children with hCP. Electronic databases (PubMed, PEDro, Web of Science, CINAHL, and SpringerLink) were searched to identify studies assessing hand function in children with hCP. The search was performed using keywords (e.g., “hemiplegia”). An iterative approach verified by two authors was used to select the studies. Articles which reported quantitative data for children with hCP on any items of a specified set of hand evaluations were included. Measures were sorted into three categories: quantitative neuromechanics, clinical assessments, and clinical functional evaluations. RESULTS: Initial searches returned 1536 articles, 131 of which were included in the final review. Trends between assessment scores and age were examined for both hands. CONCLUSION: While several studies have evaluated hand function in children with hCP, the majority relied on clinical scales, assessments, or qualitative descriptions. Further assessments of kinematics, kinetics, and muscle activation patterns are needed to identify the underlying impairment mechanisms that should be targeted for treatment.}, number={1}, journal={JOURNAL OF PEDIATRIC REHABILITATION MEDICINE}, author={McCall, James V and Ludovice, Miranda C. and Elliott, Catherine and Kamper, Derek G.}, year={2022}, pages={211–228} }