1
|
Seyhan-Bıyık K, Erdem S, Kerem Günel M. The effects of postural control and upper extremity functional capacity on functional Independence in preschool-age children with spastic cerebral palsy: a path model. Physiother Theory Pract 2024; 40:1054-1063. [PMID: 36380714 DOI: 10.1080/09593985.2022.2148227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the effects of postural control and upper extremity functional capacity on functional independence and identify whether quality of upper extremity skills mediates the effects of postural control on functional independence in preschool-age children with spastic cerebral palsy (CP). METHODS 106 children with CP -mean age 43.4 ± 11.3 (24-71 months)- were included in this cross-sectional study. Postural control, upper extremity functional capacity, and functional independence in activities of daily living were evaluated using the Early Clinical Assessment of Balance (ECAB), Quality of Upper Extremity Skills Test (QUEST), and the Functional Independence Measure of Children (WeeFIM), respectively. A path model was used to evaluate the total, direct, and indirect effects. RESULTS According to the path model, ECAB (direct effect; r = 0.391, p < 0.01, indirect effect; r = 0.398) and QUEST (direct effect; r = 0.493, p < 0.01) had an impact on WeeFIM. In addition, QUEST had mediating effects on the relationship between ECAB and WeeFIM. The path model explained 71% of the variation in functional independence of the participants. CONCLUSION In the management of CP in preschool-age children, the focus should be on improving not only upper extremity capacity but also postural control to help improve functional independence in activities of daily living.
Collapse
Affiliation(s)
- Kübra Seyhan-Bıyık
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| | - Sabri Erdem
- Faculty of Business, Dokuz Eylül University, Buca, Turkey
| | - Mintaze Kerem Günel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| |
Collapse
|
2
|
Gerard A, Toussaint-Thorin M, Mohammad Y, Letellier G, Fritot S, Masson S, Duhamel A, Donskoff C, Zagame Y, Beghin L, Gottrand L. PROPENSIX: pressure garment therapy using compressive dynamic Lycra ® sleeve to improve bi-manual performance in unilateral cerebral palsy: a multicenter randomized controlled trial protocol. Trials 2022; 23:117. [PMID: 35123557 PMCID: PMC8817585 DOI: 10.1186/s13063-022-06041-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Upper limb impairment affects activity and participation in children with unilateral cerebral palsy (UCP). Pressure garment therapy (PGT) using compressive dynamic Lycra® garments is an innovative intervention proposed for the management of cerebral palsy consequences. The PROPENSIX study aims to evaluate the efficacy of a therapy using a Lycra® sleeve as compared to a placebo sleeve to improve bi-manual performance measured by the Assisting Hand Assessment (AHA) in children with unilateral cerebral palsy. METHODS The PROPENSIX trial is a multicenter, prospective, placebo-controlled, double-blinded, randomized study. One hundred children with UCP, aged from 5 to 10, are randomly assigned as soon as they are recruited in a 1:1 ratio to perform usual daily activities, especially activities involving bimanual performances, with Lycra® sleeve or placebo sleeve during 6 months. The primary endpoint is the change in bimanual performance from inclusion to 6 months, evaluated by AHA. The secondary endpoints evaluate changes from inclusion to 6 months in other dimensions of the International Classification of Functioning (ICF), upper limb movement capacity assessed by Quality of Upper Extremity Skill Test (QUEST), and health-related quality of life evaluated by Pediatric Quality of Life Inventory 3.0 Cerebral Palsy Module (PedsQLTM 3.0 CP Module) and in body structures and functions domain assessed by neuro-orthopedic examination and somatosensory evoked potentials (SEP). DISCUSSION The PROPENSIX study is the largest randomized controlled trial (RCT) aiming to evaluate the efficacy of a PGT using compressive dynamic Lycra® sleeve in UCP. Enhancement of children's bimanual performance at the end of the 6 months wear of the Lycra® sleeve should improve evidence regarding this type of treatment and expand discussion about their recommendation in clinical practice. Data from secondary outcomes assessments should bring interesting arguments to discuss the Lycra® sleeve action on mobility, tonus, and sensory impairments in children with unilateral cerebral palsy. TRIAL REGISTRATION ClinicalTrials.gov NCT02086214 . Retrospectively registered on March 13, 2014 TRIAL STATUS: Study start data: December 2012. Recruitment status: completed. Primary completion date: April 2021. Estimated study completion date: December 2022. Protocol version 10 (date: February 2018).
Collapse
Affiliation(s)
- A. Gerard
- Service de Soins de Suites et Réadaptation pédiatrique, CHU Reims, AMH 47 Rue Cognacq-Jay, F-51092 Reims, France
| | - M. Toussaint-Thorin
- Service de Soins de Suites et Réadaptation pédiatrique, CHU Reims, AMH 47 Rue Cognacq-Jay, F-51092 Reims, France
| | - Y. Mohammad
- Service d’Éducation et de Soins Spécialisés à Domicile APF, 50 Square Frédéric Chopin, F-60175 Creil, France
- Maison de rééducation et d’autonomie, 20 Rue Anatole France, F-95260 Beaumont-sur-Oise, France
| | - G. Letellier
- Établissement de Santé pour Enfants et Adolescents de la région Nantaise, 58 Rue des Bourdonnières, F-44200 Nantes, France
| | - S. Fritot
- Médecine Physique et de Réadaptation Pédiatrique, CHU Amiens, 1 Rue du Professeur Christian Cabrol, F-80054 Amiens, France
| | - S. Masson
- Établissement de Soins de Suite et Réadaptation Pédiatrique Marc Sautelet APF, 10 Rue du Petit Boulevard, F-59650 Villeneuve-d’Ascq, France
| | - A. Duhamel
- CHU Lille, ULR 2694-Metrics: évaluation des technologies de santé et des pratiques médicales, University of Lille, 2 Avenue Oscar Lambret, F-59000 Lille, France
| | - C. Donskoff
- Service de Soins de Suite et de Réadaptation Pédiatrique, Centre Paul Dottin, 26 Avenue Tolosane, F-31522 Ramonville-Saint-Agne, France
| | - Y. Zagame
- Medical Z, 14 Rue Georges Cuvier, F-37550 Saint-Avertin, France
| | - L. Beghin
- CHU Lille, CIC1403 - Clinical Investigation Center, University of Lille, 2 Avenue Oscar Lambret, F-59000 Lille, France
| | - L. Gottrand
- Établissement de Soins de Suite et Réadaptation Pédiatrique Marc Sautelet APF, 10 Rue du Petit Boulevard, F-59650 Villeneuve-d’Ascq, France
- Institut d’Éducation Motrice pour enfants et adolescents Christian Dabbadie APF, 64 Rue de la Liberté, F-59650 Villeneuve-d’Ascq, France
| |
Collapse
|
3
|
Kuroda MM, Iwasaki N, Yoshikawa K, Takeuchi R, Mataki Y, Nakayama T, Nakayama J, Ohguro H, Tokeji K, Mutsuzaki H. Voluntary-assisted Upper Limb Training for Severe Cerebral Palsy Using Robotics Devices and Neuromuscular Electrical Stimulation: Three Case Reports. Prog Rehabil Med 2022; 7:20220050. [PMID: 36188138 PMCID: PMC9475054 DOI: 10.2490/prm.20220050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 08/23/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Constraint-induced movement therapy (CIMT) improves the motor function of paralyzed
upper limbs of adults after stroke. However, in patients with severe spastic cerebral
palsy (CP), the use of CIMT is not warranted. Our aim was to investigate the feasibility
and effectiveness of repetitive voluntary-assisted upper limb training (VAUT) for three
patients with severe CP using a combination of robotics [Hybrid Assistive Limb (HAL)]
and functional electrical stimulation [Integrated Volitional Control Electrical
Stimulation (IVES)]. Case: Three patients with CP were enrolled. Patients 1, 2, and 3 were 8-, 19-, and
18-year-old males, respectively. Patient 1 had spastic hemiplegia, while patients 2 and
3 had spastic quadriplegia. VAUT using single-joint HAL was performed for 1 or 2
sessions/month for 50 min/session over an 8-month period for 9–13 sessions in total. One
patient’s voluntary hand movement was insufficient, affecting his upper limb exercise
performance; therefore, IVES was required in addition to HAL. Outcome measures included
motor function of the upper limbs and use of paralyzed hands, which were measured before
and after intervention. No adverse events were observed during VAUT. After intervention,
the Action Research Arm Test scores showed improvements in all three patients. The
Children’s Hand-use Experience Questionnaire showed improvements in two patients. Discussion: The use of VAUT, together with new systems such as HAL and IVES, for severe CP is safe
and may be effective. Our study suggested that upper limb function can be improved for
patients with severe CP.
Collapse
Affiliation(s)
- Mayumi Matsuda Kuroda
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Nobuaki Iwasaki
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Kenichi Yoshikawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Ryoko Takeuchi
- Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Yuki Mataki
- Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Tomohiro Nakayama
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Junko Nakayama
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Haruka Ohguro
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Kayo Tokeji
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Hirotaka Mutsuzaki
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| |
Collapse
|
4
|
Lieber J, Gartmann T, Keller JW, van Hedel HJA. Validity and reliability of the Selective Control of the Upper Extremity Scale in children with upper motor neuron lesions. Disabil Rehabil 2021; 44:3694-3700. [PMID: 33577357 DOI: 10.1080/09638288.2021.1881171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE We evaluated the validity and intra-, inter-, and test-retest reliability of the Selective Control of the Upper Extremity Scale (SCUES) sum and item scores in patients with upper motor neuron lesions. METHODS Thirty-one boys and 15 girls (mean age ± SD: 11 years 1 month ± 3 years 9 month) with upper motor neuron lesions participated. We correlated SCUES scores with the range of motion items of the Melbourne Assessment 2 (MA2) and Box and Block Test (BBT) to establish concurrent validity and compared scores between the more and less affected side for discriminative validity. Intra-class correlation coefficients (ICC) and smallest detectable changes (SDC) indicated relative and absolute reliability. RESULTS For the more affected side, SCUES sum scores correlated well with MA2 (ρ = 0.83) and BBT (ρ = 0.77), and reliability proved high for intra-rater (ICC = 0.93, SDC = 2.55), inter-rater (ICC = 0.86, SDC = 3.58), and test-retest (ICC = 0.98, SDC = 1.41) reliability. Reliability of single items varied from 0.64 (inter-rater elbow) to 0.98 (intra-rater elbow). Limb and item scores were lower for the more affected side. CONCLUSION The SCUES limb and item scores seem valid and reliable in children with upper motor neuron lesions. While future studies should evaluate the responsiveness of the SCUES, we recommend that the same rater should score a patient twice.Implications for rehabilitationThe SCUES assesses selective voluntary motor control and appears valid and reliable in patients with upper motor neuron lesions.Test-retest reliability of the SCUES seems excellent.SCUES single item scores show concurrent validity and acceptable reliability.Limb and item scores are significantly lower for the more affected side.
Collapse
Affiliation(s)
- Jan Lieber
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Thomas Gartmann
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Donau-Universität Krems, Fakultät für Gesundheit und Medizin, Krems, Austria
| | - Jeffrey W Keller
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Doctoral Program Clinical Science, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
5
|
Johari S, Kahjoogh MA, Nezhad ZM, Hosseini SA, Zamani ZP, Shati M, Haghgoo HA. Effects of transcranial direct current stimulation combined with cognitive orientation to daily occupational performance in children with cerebral palsy: a protocol for a randomised controlled trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Children with hemiplegic cerebral palsy have limitations in activities requiring reach and manipulation of objects with their affected upper extremity. Transcranial direct current stimulation and the cognitive orientation to occupational performance approach are relatively new interventions that may lead to promising results for these children. This article describes the method of a randomised clinical trial that will compare the effects of the combination of transcranial direct current stimulation and cognitive orientation to daily occupational performance with transcranial direct current stimulation and neurodevelopmental treatment. Methods A four-armed clinical trial with a sample size of 36 participants will be performed in Tehran. Participants will be randomly divided into four groups. Group A will receive neuro-developmental treatment with sham transcranial direct current stimulation, group B will receive neurodevelopmental treatment with transcranial direct current stimulation, group C will receive cognitive orientation to daily occupational performance with sham transcranial direct current stimulation, and group D will receive cognitive orientation to daily occupational performance with transcranial direct current stimulation. The examiner will be blind to the study and assessments will be done at baseline, after the end of the intervention and 1 month after the completion of the intervention (as follow up). Data analysis will be as repeated measure analysis of variance and intention to treat. Conclusions This article describes the protocol of a clinical trial that compares the effects of the combination of transcranial direct current stimulation and cognitive orientation to daily occupational performance with the combination of transcranial direct current stimulation and neurodevelopmental treatment on upper extremity goals and functions of children with hemiplegic cerebral palsy.
Collapse
Affiliation(s)
- Sahar Johari
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mina Ahmadi Kahjoogh
- Department of Occupational Therapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Mossala Nezhad
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Poor Zamani
- Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Shati
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry
| | - Hojjat Allah Haghgoo
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
6
|
Ko EJ, Sung IY, Yuk JS. Does well-functioning hand constraint induce stress in forced-use therapy for children with unilateral cerebral palsy? Medicine (Baltimore) 2020; 99:e19016. [PMID: 32176030 PMCID: PMC7440088 DOI: 10.1097/md.0000000000019016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated the stress induced by well-functioning hand constraint in forced-use therapy (FUT) for children with unilateral spastic cerebral palsy (CP).Seventeen children with unilateral spastic CP (mean age 5.8 years) received FUT: 4-week unaffected upper limb immobilization with a short-arm Scotchcast and were encouraged to incorporate it to their daily routines and plays. They were evaluated at pretreatment, immediate post-treatment, and 6 months post-treatment. The Korea-Child Behavior Checklist (K-CBCL) was used to assess the stress degree; box and block test (BBT), Erhardt Developmental Prehension Assessment (EDPA), Quality of Upper Extremity Skill Test (QUEST), and Pediatric Motor Activity Log (PMAL), upper limb function; and Pediatric Evaluation of Disability Inventory (PEDI), daily living activities.In the preschoolers, most scores of K-CBCL tended to increase after FUT; however, there was no significant change in all scale findings after FUT. In the school-aged children, most scores of K-CBCL tended to decrease after FUT; however, there was no significant change in all scale findings after FUT. The findings of the BBT, QUEST, PMAL how often and well subscales significantly improved post-treatment (P < .05).The 4-week FUT with well-functioning hand constraint significantly improved the UL function and did not induce emotional and behavioral problems in children with unilateral spastic CP.
Collapse
Affiliation(s)
- Eun Jae Ko
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - In Young Sung
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Jin Sook Yuk
- Department of Rehabilitation Medicine, Asan Medical Center, Seoul, Republic of Korea
| |
Collapse
|
7
|
Ben-Pazi H, Aran A, Pandyan A, Gelkop N, Ginsberg G, Pollak Y, Elnatan D. Auditory stimulation improves motor function and caretaker burden in children with cerebral palsy- A randomized double blind study. PLoS One 2018; 13:e0208792. [PMID: 30543665 PMCID: PMC6292588 DOI: 10.1371/journal.pone.0208792] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 11/24/2018] [Indexed: 11/18/2022] Open
Abstract
Aim To investigate the impact of auditory stimulation on motor function in children with cerebral palsy (CP) and disabling hypertonia. Method 9 matched pairs (age: 7y5m, SD 4y1m; 13 boys; gross-motor-functional-classification-scale: median 4; manual-ability-classification-system: median 4) were randomized to receive either auditory stimulation embedded in music (study, n = 9) or music alone (sham, control, n = 9) for at least 10 minutes 4 times a week for 4 weeks. Goal-Attainment-Scale, Care-and-Comfort-Hypertonicity-Questionnaire, Gross-Motor-Function–Measure and Quality-of-Upper-Extremity-Skills-Test (QUEST) were assessed before and 5 months following intervention. Result Children receiving auditory stimulation attained more goals than children who listened to music alone (p = 0.002). Parents reported improved care and comfort in children in the study group compared to a slight deterioration in controls (p = 0.002). Upper extremity skills improved in the study group compared to controls (p = 0.006). Similar gross motor function changes were documented in both groups (p = 0.41). One participant reported increased seizure frequency; no other participants with epilepsy reported increased seizure frequency (n = 6/18) and no other adverse events were reported. Interpretation Auditory stimulation alleviated hypertonia and improved fine and gross motor functions.
Collapse
Affiliation(s)
- Hilla Ben-Pazi
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Adi Aran
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Anand Pandyan
- School of Health and Rehabilitation, Keele University, Keele, United Kingdom
| | - Nava Gelkop
- Physical therapy, Keren-Or Center, Jerusalem, Israel
- Meshi Children's Rehabilitation Center, Jerusalem, Israel
| | | | - Yehuda Pollak
- The Seymour Fox School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Debby Elnatan
- Meshi Children's Rehabilitation Center, Jerusalem, Israel
- * E-mail:
| |
Collapse
|
8
|
Pottinger HL, Rahlin M, Voigt J, Walsh ME, Fregosi CM, Duncan BR. Feasibility of an intensive outpatient Perception-Action Approach intervention for children with cerebral palsy: a pilot study. Physiother Theory Pract 2018; 36:973-988. [PMID: 30198809 DOI: 10.1080/09593985.2018.1517847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of this pilot study was (1) to evaluate feasibility of attendance and parent satisfaction with an intensive outpatient physical and occupational therapy program for young children with spastic cerebral palsy (CP) and (2) to examine changes in motor function. Methods: Sixteen children with CP, age range 18-36 months (mean 24.3 ± 6.3 months), received physical and occupational therapy sessions (30 minutes each) 5 days per week for 12 weeks. Attendance rates and parent satisfaction were assessed. Change in motor function using a one-group pre-post design was evaluated using the Gross Motor Function Measure-66 (GMFM-66), Quality of Upper Extremity Skills Test, and Pediatric Evaluation of Disability Inventory. GMFM-66 outcomes were also compared with expected outcomes using previously published normative developmental trajectories of children receiving standard therapies. Results: An average of 82% of scheduled outpatient physical and occupational therapies for 16 children were completed and the 11 parents who completed the Hills and Kitchen's Physiotherapy Outpatient Satisfaction Questionnaire were satisfied with the therapies and with their child's progress. Participants showed notable, statistically significant improvement across all activity-related measures. Conclusion: An intensive protocol of outpatient therapies utilizing Perception-Action Approach was feasible for most families of young children with spastic CP to attend at the outpatient clinic location. As this was not an experimental study, no reliable conclusions related to efficacy can be made, but the promising results suggest that further research into the effectiveness of intensive protocols is worthwhile.
Collapse
Affiliation(s)
- Heidi L Pottinger
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson, AZ, USA
| | - Mary Rahlin
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science , North Chicago, IL, USA
| | - Jessiemarie Voigt
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson, AZ, USA
| | - Michele E Walsh
- Department of Family Studies and Human Development, Norton School of Family and Consumer Sciences, University of Arizona , Tucson, AZ, USA
| | - Charlene M Fregosi
- Tucson Medical Center, Outpatient Therapies and Audiology , Tucson, AZ, USA
| | - Burris R Duncan
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson, AZ, USA
| |
Collapse
|
9
|
Hung JW, Chang YJ, Chou CX, Wu WC, Howell S, Lu WP. Developing a Suite of Motion-Controlled Games for Upper Extremity Training in Children with Cerebral Palsy: A Proof-of-Concept Study. Games Health J 2018; 7:327-334. [PMID: 30124337 PMCID: PMC6251329 DOI: 10.1089/g4h.2017.0141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: The Scratch programming language allows learner developers to write games. The Kinect2Scratch extension makes Scratch games with bodily motion control possible by connecting to Microsoft's Kinect sensor. This study examined the feasibility and possible efficacy of a suite of motion-controlled games designed for upper extremity (UE) training in children with cerebral palsy (CP) using Kinect2Scratch. Materials and Methods: This is a proof-of-concept study. We developed three games, requiring three UE movement patterns (shoulder holding, reaching, and handclap), for use in children with CP. The primary outcome was feasibility, addressed by adherence, engagement, satisfaction, and safety. The secondary outcome was efficacy, which was evaluated by Quality of Upper Extremities Skills Test (QUEST), Box and Block Test (BBT), Melbourne Assessment 2 (MA2) test, and ABILHAND-kids score. Results: Thirteen children with CP (mean age 6.9 years) received 24 sessions of training (30 minutes per session). The adherence rate was 100%. During the first 2 weeks of training, children had a significantly higher level of participation in Kinect2Scratch training than in conventional rehabilitation [Pittsburgh Participation Scale, median (interquartile range [IQR]), 6 (3–6) vs. 4 (3–6) P = 0.04]. However, during the last 2 weeks of training, there was no significant difference in participation between the Kinect2Scratch and conventional training [Pittsburgh Rehabilitation Participation Scale, median (IQR), 4 (3–5) vs. 4 (3–6) P = 0.55]. Most children enjoyed playing the games. The mean score of enjoyment was 4.54 ± 0.66. There were no adverse events during the training periods. The children had significant improvement in total score of QUEST and MA2. There were no significant improvements in BBT and ABILHAND-kids score. Conclusion: Using Kinect2Scratch games for UE training is a feasible adjunctive program for children with CP.
Collapse
Affiliation(s)
- Jen-Wen Hung
- 1 Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center , Kaohsiung, Taiwan .,2 School of Physical Therapy, College of Medicine , Chang Gung University, Taoyuan, Taiwan
| | - Yao-Jen Chang
- 3 Department of Electronic Engineering, Chung Yuan Christian University , Chung-Li, Taiwan
| | - Chiung-Xia Chou
- 1 Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center , Kaohsiung, Taiwan
| | - Wen-Chi Wu
- 1 Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center , Kaohsiung, Taiwan
| | | | - Wei-Peng Lu
- 1 Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center , Kaohsiung, Taiwan
| |
Collapse
|
10
|
Kim DH, An DH, Yoo WG. The relationship between trunk control and upper limb function in children with cerebral palsy. Technol Health Care 2018; 26:421-427. [DOI: 10.3233/thc-171073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Do Hyun Kim
- HIP&MAL Laboratory, Department of Rehabilitation Science, Inje University, Gimhae, Korea
| | - Duk-Hyun An
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Korea
| | - Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Korea
| |
Collapse
|
11
|
Kim DH, An DH, Yoo WG. Measurement of upper limb movement acceleration and functions in children with cerebral palsy. Technol Health Care 2018; 26:429-435. [DOI: 10.3233/thc-171148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Do Hyun Kim
- HIP&MAL Laboratory, Department of Rehabilitation Science, Inje University, Gimhae, Korea
| | - Duk-Hyun An
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Korea
| | - Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Korea
| |
Collapse
|
12
|
Kanitkar A, Szturm T, Parmar S, Gandhi DB, Rempel GR, Restall G, Sharma M, Narayan A, Pandian J, Naik N, Savadatti RR, Kamate MA. The Effectiveness of a Computer Game-Based Rehabilitation Platform for Children With Cerebral Palsy: Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2017; 6:e93. [PMID: 28526673 PMCID: PMC5454217 DOI: 10.2196/resprot.6846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/03/2017] [Accepted: 02/03/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is difficult to engage young children with cerebral palsy (CP) in repetitive, tedious therapy. As such, there is a need for innovative approaches and tools to motivate these children. We developed the low-cost, computer game-based rehabilitation platform CGR that combines fine manipulation and gross movement exercises with attention and planning game activities appropriate for young children with CP. OBJECTIVE The objective of this study is to provide evidence of the therapeutic value of CGR to improve upper extremity (UE) motor function for children with CP. METHODS This randomized controlled, single-blind, clinical trial with an active control arm will be conducted at 4 sites. Children diagnosed with CP between the ages of 4 and 10 years old with moderate UE impairments and fine motor control abnormalities will be recruited. RESULTS We will test the difference between experimental and control groups using the Quality of Upper Extremity Skills Test (QUEST) and Peabody Developmental Motor Scales, Second Edition (PDMS-2) outcome measures. The parents of the children and the therapist experiences with the interventions and tools will be explored using semi-structured interviews using the qualitative description approach. CONCLUSIONS This research protocol, if effective, will provide evidence for the therapeutic value and feasibility of CGR in the pediatric rehabilitation of UE function. TRIAL REGISTRATION Clinicaltrials.gov NCT02728375; http:https://clinicaltrials.gov/ct2/show/NCT02728375 (Archived by WebCite at http://www.webcitation.org/6qDjvszvh).
Collapse
Affiliation(s)
- Anuprita Kanitkar
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tony Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sanjay Parmar
- SDM College of Medical Sciences and Hospital, Rajiv Gandhi University of Health Sciences, Dharwad, India
| | - Dorcas Bc Gandhi
- Christian Medical College and Hospital, Department of Neurology, Baba Farid University of Health Sciences, Ludhiana, India
| | - Gina Ruth Rempel
- Max Rady College of Medicine, Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Restall
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Monika Sharma
- Christian Medical College and Hospital, Department of Pediatrics, Baba Farid University of Health Sciences, Ludhiana, India
| | - Amitesh Narayan
- Kasturba Medical College, Department of Physiotherapy, Manipal University, Mangalore, India
| | - Jeyaraj Pandian
- Christian Medical College and Hospital, Department of Neurology, Baba Farid University of Health Sciences, Ludhiana, India
| | - Nilashri Naik
- Department of Physiotherapy, Ushas School for Exceptional Children, Hubli, India
| | - Ravi R Savadatti
- SDM College of Physiotherapy, Rajiv Gandhi University of Health Sciences, Dharwad, India
| | | |
Collapse
|
13
|
Elvrum AKG, Saether R, Riphagen II, Vik T. Outcome measures evaluating hand function in children with bilateral cerebral palsy: a systematic review. Dev Med Child Neurol 2016; 58:662-71. [PMID: 27121675 DOI: 10.1111/dmcn.13119] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2016] [Indexed: 11/27/2022]
Abstract
AIM To review outcome measures used to evaluate hand function, with emphasis on manual capacity and performance, in children with bilateral cerebral palsy (CP), to describe the content and measurement properties of such measures, and to investigate the quality of the studies that have examined these properties. METHOD Embase, MEDLINE, PubMed, and CINAHL were searched. The COSMIN-criteria (COnsensus-based Standards for the selection of health Measurement INstruments) were used to assess the quality of studies and the Terwee criteria were used to assess the result of the studies. RESULTS Five hand function measures were identified from 16 papers. The strongest level of evidence for aspects of validity and reliability was found for the Melbourne Assessment 2, assessing unimanual capacity, and for the questionnaire ABILHAND-Kids, assessing perceived manual ability in daily activities. However, evidence for the responsiveness of these measures is missing. INTERPRETATION Further high-quality studies providing evidence for responsiveness, as well as for additional aspects of validity and reliability of the Melbourne Assessment 2 and the ABILHAND-Kids, are needed. Furthermore, there is a need to develop appropriate outcome measures evaluating how children with bilateral CP use their hands when handling objects in bimanual tasks.
Collapse
Affiliation(s)
- Ann-Kristin G Elvrum
- Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rannei Saether
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Paediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ingrid I Riphagen
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein Vik
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
14
|
Gerber CN, Labruyère R, van Hedel HJA. Reliability and Responsiveness of Upper Limb Motor Assessments for Children With Central Neuromotor Disorders. Neurorehabil Neural Repair 2015; 30:19-39. [PMID: 25921350 DOI: 10.1177/1545968315583723] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background. To investigate the effectiveness of upper limb rehabilitation, sound measures of upper limb function, capacity, and performance are paramount. Objectives. This systematic review investigates reliability and responsiveness of upper limb measurement tools used in pediatric neurorehabilitation. Methods. A 2-tiered search was conducted up to July 2014. The first search identified upper limb motor assessments for 1- to 18-year-old children with neuromotor disorders. The second search examined the psychometric properties of the tools. Methodological quality was rated according to COSMIN guidelines, and results for each tool were assembled in a “best evidence synthesis.” Furthermore, we delineated whether tools were unimanual or bimanual tests and if they measured recovery or did not distinguish between physiological and compensatory movements. Results. The first search delivered 2546 hits. Of these, 110 articles on 51 upper limb assessment tools were included. The second search resulted in 58 studies on reliability, 11 on measurement error, and 10 on responsiveness. Best evidence synthesis revealed only 2 assessments with moderate positive evidence for reliability, whereas no evidence on measurement error and responsiveness was found. The Melbourne Assessment showed moderate positive evidence for interrater and a fair positive level of evidence for intrarater reliability. The Pediatric Motor Activity Log Revised revealed moderate positive evidence for test–retest reliability. Conclusions. There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in children with neuromotor disorders. To date, upper limb rehabilitation trials in children and adolescents risk being biased by insensitive measurement tools lacking reliability.
Collapse
Affiliation(s)
- Corinna N. Gerber
- Rehabilitation Center for Children and Adolescents, Affoltern am Albis, Switzerland
- University Children’s Hospital Zurich, Zurich, Switzerland
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Rob Labruyère
- Rehabilitation Center for Children and Adolescents, Affoltern am Albis, Switzerland
- University Children’s Hospital Zurich, Zurich, Switzerland
| | - Hubertus J. A. van Hedel
- Rehabilitation Center for Children and Adolescents, Affoltern am Albis, Switzerland
- University Children’s Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
15
|
Silva DBR, Funayama CAR, Pfeifer LI. Manual Ability Classification System (MACS): reliability between therapists and parents in Brazil. Braz J Phys Ther 2015; 19:26-33. [PMID: 25651133 PMCID: PMC4351605 DOI: 10.1590/bjpt-rbf.2014.0065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 07/07/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND: The Manual Ability Classification System (MACS) has been widely used to describe
the manual ability of children with cerebral palsy (CP); however its reliability
has not been verified in Brazil. OBJECTIVE: To establish the inter- and intra-rater reliability of the Portuguese-Brazil
version of the MACS by comparing the classifications given by therapists and
parents of children with CP. METHOD: Data were obtained from 90 children with CP between the ages of 4 and 18 years,
who were treated at the neurology and rehabilitation clinics of a Brazilian
hospital. Therapists (an occupational therapist and a student) classified manual
ability (MACS) through direct observation and information provided by parents.
Therapists and parents used the Portuguese-Brazil version of the MACS. Intra- and
inter-rater reliability was obtained using unweighted Kappa coefficient (k) and
intra-class correlation coefficient (ICC). The Chi-square test was used to
identify the predominance of disagreements in the classification of parents and
therapists. RESULTS: An almost perfect agreement resulted among therapists [K=0.90 (95% CI 0.83-0.97);
ICC=0.97 (95%CI 0.96-0.98)], as well as with intra-rater (therapists), with Kappa
ranging between 0.83 and 0.95 and ICC between 0.96 and 0.99 for the evaluator with
more and less experience in rehabilitation, respectively. The agreement between
therapists and parents was fair [K=0.36 (95% CI 0.22-0.50); ICC=0.79 (95% CI
0.70-0.86)]. CONCLUSIONS: The Portuguese version of the MACS is a reliable instrument to be used jointly by
parents and therapists.
Collapse
Affiliation(s)
- Daniela B R Silva
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Carolina A R Funayama
- Departamento de Neurociências e Ciências do Comportamento, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Luzia I Pfeifer
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| |
Collapse
|
16
|
Gelkop N, Burshtein DG, Lahav A, Brezner A, Al-Oraibi S, Ferre CL, Gordon AM. Efficacy of constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy in an educational setting. Phys Occup Ther Pediatr 2015; 35:24-39. [PMID: 24983295 DOI: 10.3109/01942638.2014.925027] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We examined the efficacy of modified constraint-induced movement therapy (CIMT) and hand-arm bimanual intensive therapy (HABIT) in a special education preschool/kindergarten in Israel. Twelve children (1.5-7 years) with congenital hemiplegic cerebral palsy were randomized to receive modified CIMT (n = 6) or HABIT (n = 6). Occupational and physical therapists administered usual and customary care for 8 weeks; children then crossed over to receive CIMT or HABIT 2 hr/day, 6 days/week for 8 weeks from their occupational therapist. The Assisting Hand Assessment and Quality of Upper Extremity Skills Test were administered 2 months prior to the intervention, immediately before, immediately after intervention, and 6 months after the first baseline assessment. Both groups demonstrated no change during baseline and comparable improvement following CIMT and HABIT (p < .001), which was maintained at 6-month follow-up. Results suggest that modified CIMT and HABIT provided in school-based settings can lead to improvements in quality of bimanual skill and movement patterns.
Collapse
|
17
|
Kwon JY, Chang WH, Chang HJ, Yi SH, Kim MY, Kim EH, Kim YH. Changes in diffusion tensor tractographic findings associated with constraint-induced movement therapy in young children with cerebral palsy. Clin Neurophysiol 2014; 125:2397-403. [PMID: 24746686 DOI: 10.1016/j.clinph.2014.02.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 02/26/2014] [Accepted: 02/27/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of the study was to determine whether constraint-induced movement therapy (CIMT) could lead to changes in diffusion tensor tractography (DTT) associated with clinical improvement in young children with unilateral cerebral palsy (CP). METHODS A standardized pediatric CIMT protocol (4weeks, 120h of constraint) was used on 10 children with unilateral CP who were younger than 5years. DTT was performed in five participants before and after the intervention. Clinical outcome was measured by using the Pediatric Motor Activity Log (PMAL), Quality of Upper Extremity Skills Test (QUEST), and self-care domain of the Pediatric Evaluation of Disability Inventory. RESULTS In two patients, the affected corticospinal tract (CST) visible on pretreatment DTT became more prominent on posttreatment DTT. In one patient, the affected CST was not visible on pretreatment DTT, but was visible on posttreatment DTT. All the clinical outcomes significantly improved in the CIMT group compared with the control group. Changes in the PMAL how often scale (PMAL-HO) score significantly differed between the CIMT and control groups. CONCLUSIONS Changes in the properties of the affected CST on DTT were accompanied with improved arm function after CIMT in the children with CP. SIGNIFICANCE CIMT might lead to CST reorganization in young children with CP.
Collapse
Affiliation(s)
- Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Republic of Korea
| | - Hyun Jung Chang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; Department of Physical and Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Sook-Hee Yi
- Department of Pediatric Rehabilitation, Seoul, Republic of Korea
| | - Min-Young Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Eun-Hye Kim
- Department of Physical and Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Republic of Korea.
| |
Collapse
|
18
|
Lee JS, Lee KB, Lee YR, Choi YN, Park CW, Park SD, Jung DH, Lee CS. Botulinum Toxin Treatment on Upper Limb Function in School Age Children With Bilateral Spastic Cerebral Palsy: One Year Follow-up. Ann Rehabil Med 2013; 37:328-35. [PMID: 23869330 PMCID: PMC3713289 DOI: 10.5535/arm.2013.37.3.328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 10/11/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To prospectively investigate the long-term effects of botulinum toxin treatment on the upper limb function and performance of school age children with spastic bilateral cerebral palsy, who have limitations in performing activities of daily living and school activities, due to spasticity of the upper extremities. METHODS Botulinum type A toxin (BoNT-A) was injected into 24 spastic upper limbs of 15 children. We used a Modified Ashworth Scale and a Modified Tardieu Scale for the evaluation of upper limb spasticity, and Quality of Upper Extremity Skills Test (QUEST), Canadian Occupational Performance Measure (COPM), and Test of Visual-Motor Skills-Revised (TVMS-R) for the evaluation of upper limb function and performance. RESULTS Upper limb spasticity continuously decreased until the end of the one-year follow-up. Upper limb function on QUEST and COPM showed the best performance at 3 months and deteriorated slightly, but still showed a significantly better performance at 9 and 12 months than at pre-injection. In more functional nine subjects who could perform TVMS-R, the performance enhancement effects remained constant after 12 months, suggesting that the reduced spasticity led to the learning effect acquired by the repeated use of the affected upper limb. CONCLUSION For school age children with bilateral spastic cerebral palsy whose upper limb functions are important, BoNT-A injections seem to be of help in the performance of school activities and activities of daily living.
Collapse
Affiliation(s)
- Jee Sun Lee
- Department of Rehabilitation Medicine, Seoul Rehabilitation Hospital, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Kong EJ, Chun KA, Jeong JH, Cho IH. Brain SPECT Analysis After Constraint-Induced Movement Therapy in Young Children with Hemiplegic Cerebral Palsy: Case Report. Nucl Med Mol Imaging 2013; 47:119-24. [PMID: 24900092 DOI: 10.1007/s13139-013-0200-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 03/05/2013] [Accepted: 03/10/2013] [Indexed: 11/25/2022] Open
Abstract
Constraint-induced movement therapy (CIMT) was shown recently to be promising for improving upper-limb function in children with cerebral palsy (CP). This study investigated the changes in cerebral perfusion with single-photon emission computerized tomography (SPECT) after modified CIMT (child-friendly CIMT) in young hemiplegic girls. Two young children with left hemiplegic CP were studied with SPECT at rest before and after the CIMT period, and they also performed standardized upper motor function tests [Jebsen hand function test, quality of upper extremity skills test (QUEST), and dynamic electromyography (EMG)]. The cerebral perfusion SPECT revealed regional perfusion increase in the motor cortex area in the affected hemisphere, and the changes associated with functional gain. Our cases showed that intensive movement therapy appears to change local cerebral perfusion and SPECT could show these changes in children with hemiplegic CP.
Collapse
Affiliation(s)
- Eun-Jung Kong
- Department of Nuclear Medicine, Yeungnam University Hospital, Namgu Daemyung 5-dong 317-1, 705-717 Daegu, South Korea
| | - Kyung-Ah Chun
- Department of Nuclear Medicine, Yeungnam University Hospital, Namgu Daemyung 5-dong 317-1, 705-717 Daegu, South Korea
| | - Ju-Hye Jeong
- Department of Nuclear Medicine, Yeungnam University Hospital, Namgu Daemyung 5-dong 317-1, 705-717 Daegu, South Korea
| | - Ihn-Ho Cho
- Department of Nuclear Medicine, Yeungnam University Hospital, Namgu Daemyung 5-dong 317-1, 705-717 Daegu, South Korea
| |
Collapse
|
20
|
Choi YC, Park SJ, Lee MH, Kim JS. The Effects of Trunk Muscle Strengthening Exercises on Balance Performance of Sitting Posture and Upper Extremity Function of Children with Spastic Diplegic Cerebral Palsy. ACTA ACUST UNITED AC 2013. [DOI: 10.13066/kspm.2013.8.1.117] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
21
|
Assessment tools and classification systems used for the upper extremity in children with cerebral palsy. Clin Orthop Relat Res 2012; 470:1257-71. [PMID: 21932104 PMCID: PMC3314769 DOI: 10.1007/s11999-011-2065-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Clinicians interested in assessment and outcome measurement of upper extremity (UE) function and performance in children with cerebral palsy (CP) must choose from a wide range of tools. QUESTIONS/PURPOSES We systematically reviewed the literature for UE assessment and classification tools for children with CP to compare instrument content, methodology, and clinical use. METHODS We searched Health and Psychosocial Instruments (HaPI), US National Library of Medicine (PubMed), and Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus) databases (1937 to the present) to identify UE assessment and outcomes tools. We identified 21 tools for further analysis and searched HaPI, PubMed, CINAHL Plus, and Google Scholar ( http://scholar.google.com/schhp?tab=ws ) databases to identify all validity and reliability studies, systematic reviews, and original references for each of the 21 tools. RESULTS The tools identified covered ages birth to adulthood. International Classification of Functioning, Disability and Health domains addressed by these tools included body function, body structure, activities and participation, and environmental factors. Eleven of the tools were patient or family report, seven were clinician-based observations, and three tools could be used in either fashion. All of the tools had published evidence of validity. Nine of the tools were specifically designed for use in subjects with CP. Two of the tools required formal certification before use. Ten of the tools were provided free of charge by the investigators or institution who developed them. CONCLUSIONS Familiarity with the psychometric and clinometric properties of assessment and classification tools for the UE in children with CP greatly enhances a clinician's ability to select and use these tools in daily clinical practice for both clinical decision-making and assessment of outcome.
Collapse
|
22
|
Thorley M, Lannin N, Cusick A, Novak I, Boyd R. Reliability of the quality of upper extremity skills test for children with cerebral palsy aged 2 to 12 years. Phys Occup Ther Pediatr 2012; 32:4-21. [PMID: 21838618 DOI: 10.3109/01942638.2011.602389] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 2-12 years. METHOD Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total, domain, and item scores were calculated. RESULTS Total scores inter-rater reliability, Intra-class Correlation Coefficient (ICC) was 0.86, and for intra-rater reliability, ICC was 0.96. Domains had high reliability (ICC > 0.80) within raters and between raters except for grasp (moderate at ICC = 0.67). Item inter-rater reliability was moderate or better for 80% of items; item intra-rater reliability was moderate or better for 87% of items. Total score internal consistency was high (α = 0.97). IMPLICATIONS The QUEST has proven reliability for children with CP aged 18 months to 8 years. This study demonstrates strong reliability for children aged 2-12 years.
Collapse
Affiliation(s)
- Megan Thorley
- Queensland Cerebral Palsy Health Service, Royal Children's Hospital, Herston, Australia. Megan
| | | | | | | | | |
Collapse
|
23
|
Her JG, Woo JH, Ko J. Reliability of the Pediatric Balance Scale in the Assessment of the Children with Cerebral Palsy. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.301] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Ji-Hea Woo
- Department of Physical Therapy, Hallym College
| | - Jooyeon Ko
- Department of Rehabilitation Medicine, CHA University, CHA Bundang Medical Center
| |
Collapse
|
24
|
Smitherman JA, Davids JR, Tanner S, Hardin JW, Wagner LV, Peace LC, Gidewall MA. Functional outcomes following single-event multilevel surgery of the upper extremity for children with hemiplegic cerebral palsy. J Bone Joint Surg Am 2011; 93:655-61. [PMID: 21471419 DOI: 10.2106/jbjs.j.00295] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Outcomes following single-event multilevel surgery of the upper extremity for children with cerebral palsy have not been well described in the literature. Since 1996, all children with hemiplegic cerebral palsy at our institution thought to be candidates for upper extremity surgery have had serial Shriners Hospital for Children Upper Extremity Evaluation performed for both clinical decision making and outcome assessment. The goal of the current study was to determine the functional outcomes, as described by the Shriners Hospital for Children Upper Extremity Evaluation, following single-event multilevel surgery of the upper extremity in children with hemiplegic cerebral palsy. METHODS The study design was a retrospective, case-control series. The case group consisted of forty children with hemiplegic cerebral palsy who underwent upper-extremity single-event multilevel surgery. The control group consisted of twenty-six children with hemiplegic cerebral palsy who had not received any upper-extremity interventions. The spontaneous functional analysis, dynamic positional analysis, and grasp-release analysis sections of the Shriners Hospital for Children Upper Extremity Evaluation were compared between the two groups. RESULTS The operative and nonoperative groups were comparable with respect to age (p = 0.09), sex (p = 0.97), initial spontaneous functional analysis scores (p = 0.37), dynamic positional analysis scores (p = 0.73), and grasp-release analysis scores (p = 0.16). For the single-event multilevel surgery group, significant improvements were noted for the mean spontaneous functional analysis score (p < 0.0001) and the mean dynamic positional analysis score (p < 0.0001), but not the mean grasp-release analysis score (p = 0.75). For the nonoperative control group, no significant changes were noted for the mean spontaneous functional analysis score (p = 0.89), the mean dynamic positional analysis score (p = 0.98), or the mean grasp-release analysis score (p = 0.36). Significant differences were noted between the single-event multilevel surgery and nonoperative control groups for the mean changes in the spontaneous functional analysis score (p = 0.01) and the mean change in the dynamic positional analysis score (p < 0.0001), but not the mean changes in the grasp-release analysis score (p = 0.56). CONCLUSIONS Children with hemiplegic cerebral palsy showed significantly improved dynamic segmental alignment and, to a lesser degree, spontaneous use of the upper extremity following single-event multilevel surgery compared with a comparable nonoperative control group. However, the grasp-release ability did not significantly improve in either the operative or nonoperative group.
Collapse
|
25
|
Gilmore R, Sakzewski L, Boyd R. Upper limb activity measures for 5- to 16-year-old children with congenital hemiplegia: a systematic review. Dev Med Child Neurol 2010; 52:14-21. [PMID: 19811513 DOI: 10.1111/j.1469-8749.2009.03369.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This systematic review aimed to compare the validity, reliability, evaluative validity, and clinical utility of upper limb activity measures for children aged 5 to 16 years with congenital hemiplegia. METHOD Electronic databases were searched to identify assessments that measure upper limb activity available for use and for which published validity and reliability data for the population are obtainable. Assessment items were coded according to the International Classification of Functioning, Disability and Health (ICF) categories to determine if at least 35% of the assessment items fell within the activity component of the ICF. Assessments that met these criteria were included in the review. RESULTS Thirty-eight measures were identified, and five met the inclusion criteria. The best measure of unimanual capacity was the Melbourne Assessment of Unilateral Upper Limb Function (MUUL); however, the Shriners Hospital Upper Extremity Evaluation (SHUEE) and the Quality of Upper Extremity Skills Test (QUEST) could also be considered, depending on the type of information required. The performance-based measure of bimanual upper limb activity in children with hemiplegia with the best psychometric properties was the Assisting Hand Assessment (AHA). The ABILHAND-Kids is a parent-report, performance-based questionnaire with excellent clinical utility and psychometric properties. INTERPRETATION Clinicians may choose to use more than one of these measures to detect changes in unimanual or bimanual upper limb activity.
Collapse
Affiliation(s)
- Rose Gilmore
- Brain Research Institute, Melbourne, Victoria, Australia
| | | | | |
Collapse
|
26
|
Aarts PBM, Jongerius PH, Geerdink YA, Geurts AC. Validity and reliability of the VOAA-DDD to assess spontaneous hand use with a video observation tool in children with spastic unilateral cerebral palsy. BMC Musculoskelet Disord 2009; 10:145. [PMID: 19939255 PMCID: PMC2790438 DOI: 10.1186/1471-2474-10-145] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 11/25/2009] [Indexed: 11/13/2022] Open
Abstract
Background In 2003 new computer software, the VOAA (Video Observations Aarts and Aarts), was designed to score and evaluate two important aspects of spontaneous upper limb use, i.e. overall duration and frequency of specific behaviours. The aim of this study was to investigate the test-retest, interrater and intrarater reliability and the construct validity of a new module, the VOAA-DDD, to determine developmental disregard in children with spastic unilateral cerebral palsy (CP). Methods A test-retest design with three raters for reliability and a two-group design for construct validity were used. Subjects were a total of 20 children with spastic unilateral CP equally divided in two age groups (2.5-5 and 5-8 years), and 56 healthy children of the same age groups. Overall duration and frequency of specific behaviours of the affected arm and hand were assessed during a task demanding ('stringing beads') and a task stimulating ('decorating a muffin') the use of both hands. Reliability was estimated by intraclass correlation coefficients (ICCs). Construct validity was assessed by comparing children with CP to healthy children. Results All ICCs exceeded 0.87. In contrast with healthy children, children with CP used their affected hand less during the 'muffin' task compared to the 'beads' task. Of the children with CP, 90% in the age group of 2.5-5 years and 50% in the age group of 5-8 years showed values exceeding the extreme values of healthy controls, respectively, indicating developmental disregard. Conclusion The VOAA-DDD is a reliable and valid instrument to assess spontaneous use of the affected arm and hand in order to determine developmental disregard in children with spastic unilateral CP.
Collapse
Affiliation(s)
- Pauline B M Aarts
- Department of Pediatric Rehabilitation, Sint Maartenskliniek, Hengstdal 3,6522 JV Nijmegen, the Netherlands.
| | | | | | | |
Collapse
|
27
|
Tucker CA, Montpetit K, Bilodeau N, Dumas HM, Fragala-Pinkham MA, Watson K, Gorton GE, Ni P, Hambleton RK, Mulcahey MJ, Haley SM. Development of a parent-report computer-adaptive test to assess physical functioning in children with cerebral palsy II: upper-extremity skills. Dev Med Child Neurol 2009; 51:725-31. [PMID: 19416341 DOI: 10.1111/j.1469-8749.2009.03267.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The specific aims of this study were to (1) examine the psychometric properties (unidimensionality, differential item functioning, scale coverage) of an item bank of upper-extremity skills for children and adolescents with cerebral palsy (CP); (2) evaluate a simulated computer-adaptive test (CAT) using this item bank; (3) examine the concurrent validity of the CAT with the Pediatric Outcomes Data Collection Instrument (PODCI) upper-extremity core scale; and (4) determine the discriminant validity of the simulated CAT with Manual Ability Classification System (MACS) levels and CP type (i.e. diplegia, hemiplegia, or quadriplegia). Parents (n=180) of children and adolescents with CP (spastic diplegia 49%, hemiplegia 22%, or quadriplegia 28%) consisting of 102 males and 78 females with a mean age of 10 years 6 months (SD 4y 1mo, range 2-21y), and MACS levels I through V participated in calibration of an item pool and completed the PODCI. Confirmatory factor analyses supported a unidimensional model using 49 of the 53 upper-extremity items. Simulated CATs of 5, 10, and 15 items demonstrated excellent accuracy (intraclass correlation coefficient [ICCs] >0.93) with the full item bank, had high correlations with the PODCI upper-extremity core scale score (ICC 0.79), and discriminated among MACS levels. The simulated CATs demonstrated excellent overall content coverage over a wide age span and severity of upper-extremity involvement. The future development and refinement of CATs for parent report of physical function in children and adolescents with CP is supported by our work.
Collapse
|