Effects Of Spiral Strapping Systems On Upper Limb Function In Unilateral Spastic Cerebral Palsy

Assessment of upper limb movement quality and functional performance, including reaching, grasping, release, and coordination during task-oriented activities.

Assessment of gross manual dexterity by counting the number of blocks transferred from one compartment to another within 60 seconds using the affected hand.

Measurement of maximal voluntary grip strength of the affected hand using a digital hand dynamometer under standardized testing conditions.

Evaluation of spasticity severity in affected upper limb muscles by assessing resistance to passive stretch at different velocities using the Modified Tardieu Scale. Modified Tardieu Scale (MTS): We used the Modified Tardieu Scale to assess spasticity. Two scores are recorded: R1 (angle of muscle reaction at fast stretch) and R2 (full passive range of motion at slow stretch), both measured in degrees (approximately 0-180°, depending on the joint). The difference R2-R1 (degrees) reflects the dynamic component of spasticity; a larger R2-R1 indicates greater spasticity/dynamic catch (i.e., worse outcome). In addition, the quality of muscle reaction is graded on an ordinal scale from 0 to 4, where higher scores indicate a stronger/faster catch or clonus

Assessment of active joint range of motion of the affected upper extremity, including shoulder external rotation, forearm supination, and wrist extension, measured using video-based motion analysis with Kinovea software.

Parent-reported assessment of the child's hand use, efficiency, and experience during bimanual daily activities. Child Hand Skills Questionnaire: The questionnaire includes 21 items assessing hand skill performance in daily activities. Each item is rated on a 3-point scale (1 = very difficult, 2 = difficult, 3 = not difficult); items may be marked not applicable. Total raw score range: 21-63 (higher scores indicate better hand skills / less difficulty).

Evaluation of functional independence and participation in daily activities, including self-care, mobility, and social function, based on caregiver reports. PEDI assesses functional performance in Self-Care, Mobility, and Social Function using three scales: Functional Skills (items scored 0-1), Caregiver Assistance (items scored 0-5), and Modifications. Domain scores are reported as scaled scores ranging from 0 to 100, where 0 indicates low functioning and 100 indicates high functioning; higher scores represent greater functional ability/independence (better outcome)

Caregiver-reported satisfaction with the spiral taping systems, including comfort, ease of use, and perceived benefit, measured using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). QUEST 2.0 is a 12-item questionnaire assessing satisfaction with an assistive technology device and related services (8 device items and 4 service items). Each item is rated on a 5-point satisfaction scale (1-5), from 1 = not satisfied at all to 5 = very satisfied. Higher scores indicate greater satisfaction (better outcome). Total and subscale scores are typically reported as the mean item score (range 1-5).