[Effect of surgical treatment on patients with cerebral palsy: improvement of manual dexterity but not of perceived competence].

Objective: To examine the relationship between impaired manual dexterity and perceived competence in children with cerebral palsy and the effect of surgical intervention, with the question whether the perceived competence is applicable as an outcome measure for surgical reconstruction of hand function.

Method: The Dutch version of the Michigan Hand Outcomes Questionnaire (MHQ-DLV) for perceived manual dexterity and the Dutch version of the Harter Scales for perceived competence were used in a sample of 25 children and adolescents with hemiplegic cerebral palsy of the spastic type. 10 patients underwent surgical treatment to improve hand function. In this 'surgical group' both questionnaires were repeated at least one year postoperatively.

Results: Perceived manual dexterity was low (mean MHQ-DLV-score: 63.2; SD: 18.9), as were the scores of perceived overall competence (2.92; SD: 0.84), social competences (2.66; SD: 0.92) and athletic competences (2.29; SD: 0.79). There was no correlation between the degree of perceived impairment in manual dexterity and the perceived competence (r = -0.16; p = 0.43). After surgical reconstruction manual dexterity improved (mean increase in score: 24; SD: 10.4; p < 0.01), but perceived competence did not improve (p = 0.39).

Conclusion: Children with cerebral palsy and impaired manual dexterity did have a lower perceived competence than children without this disorder. The extent to which manual dexterity was impaired did not correlate with the extent to which perceived competence was lowered. Surgical intervention substantially improved perceived manual dexterity, but perceived competence did not improve. Perceived competence does not seem to be applicable as an outcome measure for surgical reconstruction of manual dexterity.