Associations and dynamics of risk factors in hemodialysis patients

Marijke Dekker

Research output: ThesisDoctoral ThesisInternal


Children with Unilateral Spastic Cerebral palsy (USCP) have difficulty moving due to brain damage that originated before the first year of life. The restrictions occur in either the left or right side of the body. Approximately 60% of these children experience problems with their arm and/or hand function during daily activities. Muscle weakness seems to be one of the most important causes. This study looked at the usefulness of four measuring instruments that aim to measure arm and hand muscle strength in children with USCP. The results show that the measuring instruments are very suitable for discriminative use. However, the measurement error is so large that it is not clear whether the instruments can also be used for evaluation measurements. Further research into this error shows that the large measurement error is consistently reflected in similar measuring instruments. Discussion about how to calculate the measurement error is therefore necessary. It is recommended that until there is more clarity, multiple measuring instruments are used to ensure the effect of the intervention does not depend on one measuring instrument. In addition, the muscle strength of the "healthy" arm and/or hand has also been studied, and there too it appears to have less muscle strength compared to children without USCP.
Original languageEnglish
Awarding Institution
  • Maastricht University
  • Kooman, Jeroen, Supervisor
  • Kotanko, Peter, Co-Supervisor, External person
  • Konings, C.J.A.M., Co-Supervisor, External person
Award date17 Sept 2020
Publication statusPublished - 2020


  • cerebral palsy
  • measuring instruments
  • clinimetric properties
  • muscle strength

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