The Beneficial, The Bad And also Fluorouracil

Fedrizzi et?al.14 specifically studied children with unilateral CP and investigated both grip pattern and spontaneous hand use by means of nonstandardized assessments. They found no change over time in spontaneous hand use, but a slight improvement in the quality of grip at ages 4 to 7 years, which declined after 11 years of age in a subgroup with low ability. Eliasson et?al.15 reported improvement at older ages in a 13-year follow-up from ages 6 to 8 years. In 10 people with different subtypes of CP they found a 45% mean time decrease in the Jebsen´┐ŻCTaylor test of hand function and a 22% time decrease for an experimental grip-lift task. The above studies describe development of hand function for children with different types of CP, and have different perspectives on development depending on the measurement used. From previous studies it is clear that the choice of measure is crucial as an expression of the aspect of hand function described, and it also needs to be suitable for the subtype of CP studied. For children with unilateral CP, we believe that the most critical issue is how to use the affected hand in collaboration with the well-functioning, dominant hand. When investigating development of hand function for this group it is important to choose an assessment that captures this specific characteristic of hand function. In recent years the Assisting Hand Assessment (AHA) has been developed, which seeks to measure and describe how effectively children with unilateral disability use their affected hand to perform bimanual tasks.16 The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral CP between 18 months and 8 years of age. This was a prospective longitudinal study with the aim of following change over time. In this design children were included and measured at different ages (unbalanced data), which was accommodated for in a nonlinear mixed-models analysis.11 A convenience sample of 43 children with unilateral CP were recruited through community habilitation centres located mainly in Stockholm, but also in a few other regions of Sweden. Occupational therapists passed on information about the study to families with children fitting the inclusion criteria, namely a diagnosis of unilateral CP and age 18 months to 5 years. No record was taken of families who were asked but declined. The mean age for entering the study was 2 years 8 months (SD 1y 1mo), ranging from 18 months to 5 years 4 months. There was an even distribution of sexes (22 males, 21 females) and slightly more children with right-sided unilateral CP (n=25). Fourteen children had been born preterm (