Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy

Heterogeneity of Tasks and Outcome Measures in Dual Tasking Studies in Children With Cerebral Palsy: A Scoping Review

OBJECTIVE

The aims of this scoping review are to examine the available literature regarding dual tasking in children with cerebral palsy (CP) and to identify and categorize both the motor and cognitive tasks and outcome measures used primarily through the International Classification of Functioning, Disability, and Health model.

METHODS

Five electronic databases were searched. Studies were included if they: (1) were published in English; (2) included at least 1 group of children or adolescents with a diagnosis of CP; (3) assessed dual tasking as part of the study; (4) reported the method for performing the dual task; and (5) reported the outcome measures utilized.

RESULTS

Twenty-three studies with 439 children with CP were included. All studies utilized motor activities as the primary task, including walking, balance, and a functional transition. Motor secondary tasks occurred in 10 studies, cognitive secondary tasks in 12 studies, and 1 study used both. Forty-one outcome measures over 23 studies assessed the body structure and function domain, 7 measures over 6 studies assessed activity limitations, and 2 outcomes over 2 studies assessed participation.

CONCLUSION

The 23 included studies demonstrated heterogeneity in the age and function of participants, secondary tasks, and outcome measures. Future studies on dual tasking in children with CP should consider the difficulty of the primary motor or cognitive task and compare secondary tasks to establish this contribution to motor performance. Studies should incorporate activity and participation measures to assess meaningful functional outcomes.

IMPACT

Children with CP experience challenges when exposed to dual task situations. This scoping review highlights the importance of considering multiple factors when designing dual tasking studies involving children with CP to facilitate results translation, improved participation, and enhanced function. Similarly, studies should utilize activity and participation outcomes to assess quality of life.

Effects of Nonimmersive Virtual Reality Intervention on Children With Spastic Cerebral Palsy: A Meta-analysis and Systematic Review

ABSTRACT

This review aimed to assess the effectiveness of nonimmersive virtual reality intervention compared with traditional rehabilitation in improving the functions of the upper and lower limbs, balance, and social participation among children with spastic cerebral palsy. We used librarian-designed searches of 10 databases to identify research articles on randomized controlled trials that assessed the effectiveness of nonimmersive virtual reality in intervening spastic cerebral palsy patients up to April 15, 2023. Independent evaluation was conducted by two trained investigators using the evaluation criteria of randomized controlled trial quality indicated in the Cochrane Manual of Assessment "risk-of-bias tool." The Physical Therapy Evidence Database scale was used to evaluate the method and quality of the literature. Twenty-one research articles involving 779 patients with spastic cerebral palsy were included. Significant differences between the nonimmersive virtual reality rehabilitation and traditional rehabilitation groups were observed in all indicators, except for the Jebsen-Taylor Hand Function Test. Nonimmersive virtual reality intervention is effective in improving the function of the lower extremity, balance, and social participation in children with spastic cerebral palsy, but its effect on upper limb function is still controversial.

Investigation of Motor Activity, Movement Kinematics and Forward-Backwards Gait in Children with Cerebral Palsy

Our aim in this study was to examine relationships between the motor activity ability, sensor-based kinematics and forward-backwards gait characteristics of children with cerebral palsy (CP). In this prospective cross-sectional study we studied 40 children with CP. We used the Pediatric Motor Activity Log Revised (PMAL-R) to assess motor activity, evaluated motion kinematics (acceleration and angular velocity) with a sensor-based application, applied the Edinburgh Visual Gait Score (EVGS) and the Timed Up and Go Test (TUG) to observe gait performance, and used the Three Meter Backward Walk Test (3MBWT) to assess backward gait. We found moderately positive significant correlations (r1 = 0.416, r2 = 0.418, p < 0.05) between the chilidren's minimum angular velocity on PMAL-R motor activity frequency (how often) and quality (how well) scores, respectively. We also found moderately negative significant correlations (r1 = -0.529, r2 = -0.521, p < 0.05) between PMAL-R frequency (how often) and quality (how well) scores with TUG, respectively. There were moderately high positive correlations (r1 = 0.415, r2 = 0.726, p < 0.05) between EVGS scores and 3MBWT and TUG scores, respectively. We concluded that angular velocity ability was moderately related to children's motor activity and showed that physical performance tests (TUG and 3MBWT) could monitor gait function and upper extremity motor activity level, including both forward and backward walking tasks, in children with CP.