Objective:

For treatment of CP patients multidisciplinary approach is often promoted. But it is not cost-efficient to involve all medical staff plus 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. 

Design/Methods:

702 children aged 2.5 to 18 years (mean age‒6y4m) 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 also observed in 74.2% of subjects.

Conclusions:

Fine hand functioning is not only a key determinant of quality of life but also strongly interrelated with cognitive abilities in the majority of patients, highlighting hand function as a pivotal target for intervention. Thus, focusing rehabilitation strategies on fine motor skills may provide dual benefits—enhancing both functional independence and cognitive development—while ensuring a more cost-efficient and goal-oriented multidisciplinary approach to treatment.