1
|
Jovellar-Isiegas P, Cuesta García C, Jaén-Carrillo D, Palomo-Carrión R, Peña Alonso C, Roche-Seruendo LE. Somatosensation and motor performance in the less-affected and more-affected hand of unilateral cerebral palsy children: a cross-sectional study. Disabil Rehabil 2023; 45:3500-3510. [PMID: 36172643 DOI: 10.1080/09638288.2022.2127938] [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: 12/28/2021] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study aimed to examine motor performance and somatosensory processing of unilateral cerebral palsy (UCP) children in both the less-affected hand and the more-affected hand. This study is also aimed at analysing the somatosensory proccessing in the more-affected hand in relation to age and damaged hemisphere. MATERIALS AND METHODS Forty-seven children aged from 6 to 15 years (UCP = 23; TD = 24) were recruited. Grip strength, pinch strength, Box and Block Test and Jebsen Taylor Hand Function Test were used to analyse motor performance. A comprehensive somatosensory assessment battery was included: tactile registration, unilateral, bilateral and spatio-temporal perception, haptic recognition, texture perception, proprioception, pressure pain threshold and functional sensitivity. RESULTS UCP children exhibited lower performance in all aspects of motor performance measured in both the less-affected hand and the more-affected hand, except grip strength in the less-affected hand. Significant differences were found for all tests included in the somatosensory assessment in both the less-affected hand and the more-affected hand, except unilateral perception tests in the less-affected hand. CONCLUSIONS UCP children present difficulties in motor performance and somatosensory processing not only in the more-affected hand, but also in the less-affected hand. Somatosensation may be a critical driver of functional performance.Implications for rehabilitationThe less-affected hand of children with unilateral cerebral palsy should be included in both assessment and intervention programmes.Somatosensory processing should be assessed through a comprehensive battery, both in the less-affected hand and in the more-affected hand of unilateral cerebral palsy children.Somatosensory treatment must be taken into account if functional performance in the activities of daily living of unilateral cerebral palsy children is to be improved.
Collapse
Affiliation(s)
| | - César Cuesta García
- Department of Occupational Therapy, Centre for Advanced University Studies La Salle, Autonomous University of Madrid, Madrid, Spain
| | | | - Rocío Palomo-Carrión
- Faculty of Physiotherapy and Nursing, University of Castilla La Mancha, Toledo, Spain
| | | | | |
Collapse
|
2
|
Marsico P, Meier L, van der Linden ML, Mercer TH, van Hedel HJA. Feasibility, Validity, and Reliability of Lower Limb Tactile and Body Awareness Assessments in Children With Upper Motor Neuron Lesions. Arch Phys Med Rehabil 2023; 104:1447-1455. [PMID: 36935032 DOI: 10.1016/j.apmr.2023.02.017] [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: 09/07/2022] [Revised: 01/24/2023] [Accepted: 02/26/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE To investigate the feasibility, discriminative and convergent validity, and inter-rater reliability of a lower limb tactile function and 2 body awareness assessments in children with upper motor neuron (UMN) lesions. DESIGN Cross-sectional psychometric study. SETTING Pediatric rehabilitation center. PARTICIPANTS Forty individuals with UMN lesions (mean age 11.7 years, SD 3.4 years; 27 girls) and 40 neurotypically developing children of the same age participated (N=80). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We assessed the tactile threshold (TT) with monofilaments and body awareness with tactile localization tasks (TLTs) for structural (TLTaction) and spatial (TLTperception) body representation at the foot sole. We compared the test outcomes between children with UMN lesions and neurotypically developing children with the Wilcoxon signed-rank test. Furthermore, we quantified the relations between the 3 tests with Spearman correlations (rs) and the interrater reliability with quadratic weighted kappa (κQW). RESULTS About 80% of the children with UMN lesions perceived the tests easy to perform. The children with UMN lesions had significantly reduced somatosensory function compared with the neurotypically developing children. For the more affected leg, we found good relations between the TT and the TLTaction (rs=0.71; P<.001) and between the 2 TLTs (rs=0.66; P<.001), and a fair relation between the TT and the TLTperception (rs=0.31; P=.06). The inter-rater reliability analyses for the sum scores showed almost perfect agreement for the TT (κQW more affected leg 0.86; less affected leg 0.81), substantial agreement for TLTaction (κQW more affected leg 0.76; less affected leg 0.63), and almost perfect agreement for TLTperception (κQW more affected leg 0.88; less affected leg 0.74). CONCLUSION The 3 tests are feasible to assess lower limb somatosensory function in children with UMN lesions. Discriminative and convergent validity and reliability of the 3 tests were confirmed. Further studies should investigate responsiveness and association with motor function of these outcome measures.
Collapse
Affiliation(s)
- Petra Marsico
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland; Children's Research Center CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, Scotland.
| | - Lea Meier
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland; Children's Research Center CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; ZHAW, Institute for Physiotherapy, Zürich University of Applied Studies, Winterthur, Switzerland
| | - Marietta L van der Linden
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, Scotland
| | - Tom H Mercer
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, Scotland
| | - Hubertus J A van Hedel
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland; Children's Research Center CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, Scotland
| |
Collapse
|
3
|
D'Arcy E, Evans K, Afsharnejad B, Milbourn B, Bölte S, Girdler S. Assessing functioning for individuals with neurodevelopmental conditions: Current clinical practice in Australia. Aust Occup Ther J 2023; 70:43-60. [PMID: 35934786 PMCID: PMC10087051 DOI: 10.1111/1440-1630.12834] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the disability sector globally, and specifically in Australia, assessments of functioning have become key to diagnostic processes, and accessing therapy and funding. Over half of all individuals accessing support through Australia's National Disability Insurance Scheme have a neurodevelopmental condition diagnosis. Little is known about assessments of functioning for this population. METHODS A mixed methods online survey was designed to understand the current assessment of functioning practices (including clinical contexts, concepts being assessed, and assessment methods) and barriers and facilitators to clinicians using best practice. Results were analysed descriptively, and differences between professions calculated where possible. Content analysis was used to explore qualitative comments. RESULTS Clinicians from various medical and allied health backgrounds completed the survey (n = 93), with varying ranges of age, experience, and education. Clinicians reported that they assessed functioning across age, setting, sector, funding body, and individuals with a wide variety of diagnoses. Missing from current practice is a clear transdisciplinary conceptualisation of functioning. The largest barriers to best practice were limited time, large caseloads, availability of appropriate tools, and lack of clarity from funding bodies. CONCLUSIONS Missing from current practice is a clear transdisciplinary conceptualisation of functioning.These results will help inform steps forward to improve assessment of functioning practices to ensure that all individuals receive appropriate and sufficient support.
Collapse
Affiliation(s)
- Emily D'Arcy
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Kiah Evans
- Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bahareh Afsharnejad
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Benjamin Milbourn
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Sven Bölte
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| |
Collapse
|
4
|
Sidarta A, Lim YC, Wong RA, Tan IO, Kuah CWK, Ang WT. Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation. PLoS One 2022; 17:e0270693. [PMID: 35951544 PMCID: PMC9371309 DOI: 10.1371/journal.pone.0270693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Stroke-induced somatosensory impairments seem to be clinically overlooked, despite their prevalence and influence on motor recovery post-stroke. Interest in technology has been gaining traction over the past few decades as a promising method to facilitate stroke rehabilitation. This questionnaire-based cross-sectional study aimed to identify current clinical practice and perspectives on the management of somatosensory impairments post-stroke and the use of technology in assessing outcome measures and providing intervention. Participants were 132 physiotherapists and occupational therapists currently working with stroke patients in public hospitals and rehabilitation centres in Singapore. It was found that the majority (64.4%) of the therapists spent no more than half of the time per week on somatosensory interventions. Functional or task-specific training was the primary form of intervention applied to retrain somatosensory functions in stroke survivors. Standardised assessments (43.2%) were used less frequently than non-standardised assessments (97.7%) in clinical practice, with the sensory subscale of the Fugl-Meyer Assessment being the most popular outcome measure, followed by the Nottingham Sensory Assessment. While the adoption of technology for assessment was relatively scarce, most therapists (87.1%) reported that they have integrated technology into intervention. There was a common agreement that proprioception is an essential component in stroke rehabilitation, and that robotic technology combined with conventional therapy is effective in enhancing stroke rehabilitation, particularly for retraining proprioception. Most therapists identified price, technology usability, and lack of available space as some of the biggest barriers to integrating robotic technology in stroke rehabilitation. Standardised assessments and interventions targeting somatosensory functions should be more clearly delineated in clinical guidelines. Although therapists were positive about technology-based rehabilitation, obstacles that make technology integration challenging ought to be addressed.
Collapse
Affiliation(s)
- Ananda Sidarta
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore, Singapore
- * E-mail:
| | - Yu Chin Lim
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore, Singapore
| | - Russell A. Wong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Isaac O. Tan
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore, Singapore
| | - Christopher Wee Keong Kuah
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore, Singapore
- Centre for Advanced Rehabilitation Therapeutics (CART), Tan Tock Seng Hospital, Singapore, Singapore
| | - Wei Tech Ang
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- School of Mechanical & Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
5
|
Marsico P, Mercer TH, van Hedel HJA, van der Linden ML. What are the relevant categories, modalities, and outcome measures for assessing lower limb somatosensory function in children with upper motor neuron lesions? A Delphi study. Disabil Rehabil 2022:1-10. [PMID: 35906774 DOI: 10.1080/09638288.2022.2102257] [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: 11/03/2022]
Abstract
PURPOSE Somatosensory function of the lower limbs is rarely assessed in children with upper motor neuron lesions despite its potential relevance for motor function. We explored consensus regarding somatosensory categories (exteroception, proprioception, interoception, and body awareness), modalities, and outcome measures relevant to lower limb motor function. METHODS Fifteen international experts with experience of somatosensory function assessment participated in this Delphi study. Surveys of four rounds, conducted online, included questions on the relevance of somatosensory categories and modalities for motor function and on the use of potential outcome measures in clinical practice. RESULTS The experts reached consensus on the relevance of six modalities of the categories exteroception, proprioception, and body awareness. Based on their feedback, we formulated three core criteria for somatosensory outcome measures, namely suitability for clinical practice, child-friendliness, and relevance for motor function. None of the nine available outcome measures fulfilled each criterion. The experts also highlighted the importance of using and interpreting the tests in relation to the child's activity and participation. CONCLUSION There was expert consensus on three categories and six modalities of somatosensory function relevant for lower limb motor function. However, existing outcome measures will need to be adapted for use in paediatric clinical practice. IMPLICATION FOR REHABILITATIONConsensus was established for the categories and modalities of somatosensory function relevant for lower limb motor function of children with UMN lesion.Outcome measures should cover tactile function, joint movement and joint position and dynamic position sense, and spatial and structural body representation.None of the nine existing outcome measures fulfilled the core criteria: feasibility for clinical practice, child-friendliness, and relevance to motor function.
Collapse
Affiliation(s)
- Petra Marsico
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center CRC, University Children's Hospital Zurich, Zurich, Switzerland.,Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | - Tom H Mercer
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | - Hubertus J A van Hedel
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center CRC, University Children's Hospital Zurich, Zurich, Switzerland.,Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | | |
Collapse
|
6
|
Marsico P, Meier L, van der Linden ML, Mercer TH, van Hedel HJA. Psychometric Properties of Lower Limb Somatosensory Function and Body Awareness Outcome Measures in Children with Upper Motor Neuron Lesions: A Systematic Review. Dev Neurorehabil 2022; 25:314-327. [PMID: 34872425 DOI: 10.1080/17518423.2021.2011976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE A systematic review of the psychometric properties and feasibility of outcome measures assessing lower limb somatosensory function and body awareness in children with upper motor neuron lesion. METHODS We followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. Two raters independently judged the quality and risk of bias of each study. Data synthesis was performed, and aspects of feasibility were extracted. RESULTS Twelve studies investigated eleven somatosensory function measures quantifying four modalities and eight body awareness measures quantifying two modalities. The best evidence synthesis was very low to low for somatosensory function modalities and low for body awareness modalities. Few feasibility aspects were reported (e.g., the percentage or minimum age of participants able to perform the tests). CONCLUSION Current evidence on the psychometric characteristics of somatosensory function and body awareness outcome measures are relatively sparse. Further research on psychometric properties and practical application is needed.
Collapse
Affiliation(s)
- Petra Marsico
- Swiss Children's Reha, Affoltern am Albis, Switzerland.,University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.,Queen Margaret University, Edinburgh, Scotland
| | - Lea Meier
- Swiss Children's Reha, Affoltern am Albis, Switzerland.,University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | - Hubertus J A van Hedel
- Swiss Children's Reha, Affoltern am Albis, Switzerland.,University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.,Queen Margaret University, Edinburgh, Scotland
| |
Collapse
|
7
|
McLean B, Taylor S, Valentine J, Carey L, Thornton A, Elliott C. Somatosensory discrimination impairment in children with hemiplegic cerebral palsy as measured by the sense_assess© kids. Aust Occup Ther J 2021; 68:317-326. [PMID: 33738799 DOI: 10.1111/1440-1630.12729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To characterise somatosensory discrimination impairment of the upper-limb across domains of tactile discrimination, limb position sense and haptic object recognition using the sense_assess© kids and examine associations with upper-limb motor performance in children with hemiplegic cerebral palsy (CP). METHODS The sense_assess© kids was administered at one timepoint to 28 children, aged 6-15.5 years (M = 10.1, SD = 2.4), with hemiplegic CP (right hemiplegia n = 15) and Manual Ability Classification System Levels I (n = 11) and II (n = 17). Unimanual motor performance was quantified using the Box and Block Test. RESULTS Tactile discrimination was impaired in 18, limb position sense in 20, and haptic object recognition was impaired in 21 of 28 children. Over 80% (23/28) of children had impaired somatosensory discrimination in one or more domains. Low to moderate correlations were observed between each measure of somatosensory discrimination and motor performance. Manual ability classification was associated with limb position sense and haptic object recognition. A moderate inverse correlation (r = -.57, p < .01) exists between the number of somatosensory domains impaired and motor performance. CONCLUSION The frequency of somatosensory impairment in the upper limb of children in our sample was high and associated with manual ability, suggesting a need for routine assessment of somatosensation in this population.
Collapse
Affiliation(s)
- Belinda McLean
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Kids Rehab Western Australia, Child and Adolescent Health Service, Perth, WA, Australia
| | - Susan Taylor
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Occupational Therapy Department, Child and Adolescent Health Service, Perth, WA, Australia
| | - Jane Valentine
- Kids Rehab Western Australia, Child and Adolescent Health Service, Perth, WA, Australia
| | - Leeanne Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Vic., Australia.,Neurorehabilitation and Recovery, The Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia
| | - Ashleigh Thornton
- Kids Rehab Western Australia, Child and Adolescent Health Service, Perth, WA, Australia.,Division of Paediatrics, University of Western Australia, Perth, WA, Australia
| | - Catherine Elliott
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Kids Rehab Western Australia, Child and Adolescent Health Service, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| |
Collapse
|
8
|
Zarkou A, Lee SCK, Prosser L, Hwang S, Franklin C, Jeka J. Foot and ankle somatosensory deficits in children with cerebral palsy: A pilot study. J Pediatr Rehabil Med 2021; 14:247-255. [PMID: 33896853 DOI: 10.3233/prm-190643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To investigate foot and ankle somatosensory function in children with cerebral palsy (CP). METHODS Ten children with spastic diplegia (age 15 ± 5 y; GMFCS I-III) and 11 typically developing (TD) peers (age 15 ± 10 y) participated in the study. Light touch pressure and two-point discrimination were assessed on the plantar side of the foot by using a monofilament kit and an aesthesiometer, respectively. The duration of vibration sensation at the first metatarsal head and medial malleolus was tested by a 128 Hz tuning fork. Joint position sense and kinesthesia in the ankle joint were also assessed. RESULTS Children with CP demonstrated significantly higher light touch pressure and two-point discrimination thresholds compared to their TD peers. Individuals with CP perceived the vibration stimulus for a longer period compared to the TD participants. Finally, the CP group demonstrated significant impairments in joint position sense but not in kinesthesia of the ankle joints. CONCLUSIONS These findings suggest that children with CP have foot and ankle tactile and proprioceptive deficits. Assessment of lower extremity somatosensory function should be included in clinical practice as it can guide clinicians in designing more effective treatment protocols to improve functional performance in CP.
Collapse
Affiliation(s)
- Anastasia Zarkou
- Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, Atlanta, GA, USA
| | - Samuel C K Lee
- Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, USA.,Research Department, Shriners Hospital for Children, Philadelphia, PA, USA
| | - Laura Prosser
- Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sungjae Hwang
- Department of Kinesiology, University of Maryland Eastern Shore, Princess Anne, MD, USA
| | - Corinna Franklin
- Research Department, Shriners Hospital for Children, Philadelphia, PA, USA
| | - John Jeka
- Department of Kinesiology, University of Delaware, Newark, DE, USA
| |
Collapse
|
9
|
McLean B, Girdler S, Taylor S, Valentine J, Carey L, Elliott C. Experience of Engagement in a Somatosensory Discrimination Intervention for Children with Hemiplegic Cerebral Palsy: A Qualitative Investigation. Dev Neurorehabil 2019; 22:348-358. [PMID: 30113250 DOI: 10.1080/17518423.2018.1503620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: To successfully modify an intervention from an adult population for use with children with cerebral palsy, it is important to understand the components that support a child's motivation and engagement. Method: Ten children who had participated in the Sense© intervention (mean age = 11 years 2 m [SD = 2 years]; four males; Manual Ability Classification System level I = 1, II = 9) and their primary caregivers (N = 11, 10 females) were interviewed. Transcripts were analyzed using framework analysis. Results: Key themes were identified in the core domains of the Synthesis of Child, Occupational Performance and Environment in Time model. Child: children's somatosensory discrimination ability improved; Motivation: incorporating child's goals was essential, as were real-world gains; Environmental: parents were interested in having more involvement in the intervention. Conclusion: The most engaging elements of the intervention for children were the attainment of their self-selected goals. Opportunities to modify the intervention for improved partnership with parents were identified.
Collapse
Affiliation(s)
- Belinda McLean
- a School of Paediatric and Child Health , University of Western Australia, Perth, Western Australia, Australia.,b Kids Rehab Department , Perth Children's Hospital, Perth, Western Australia, Australia
| | - Sonya Girdler
- c School of Occupational Therapy and Social Work , Curtin University, Perth, Western Australia, Australia
| | - Susan Taylor
- b Kids Rehab Department , Perth Children's Hospital, Perth, Western Australia, Australia.,c School of Occupational Therapy and Social Work , Curtin University, Perth, Western Australia, Australia
| | - Jane Valentine
- a School of Paediatric and Child Health , University of Western Australia, Perth, Western Australia, Australia.,b Kids Rehab Department , Perth Children's Hospital, Perth, Western Australia, Australia
| | - Leeanne Carey
- d Occupational Therapy , Department of Community and Clinical Allied Health, School of Allied Health, La Trobe University, Melbourne, Victoria Australia.,e Neurorehabilitation and Recovery , Stroke Division, Florey Institute of Neuroscience and Mental Health , Melbourne , Victoria , Australia
| | - Catherine Elliott
- c School of Occupational Therapy and Social Work , Curtin University, Perth, Western Australia, Australia.,f Child and Adolescent Health Services , Perth , Western Australia , Australia
| |
Collapse
|
10
|
Guedin N, Fluss J, Thevenot C. Dexterity and Finger Sense: A Possible Dissociation in Children With Cerebral Palsy. Percept Mot Skills 2018; 125:718-731. [DOI: 10.1177/0031512518779473] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Both hand and finger sensory perception and motor abilities are essential for the development of skilled gestures and efficient bimanual coordination. While finger dexterity and finger sensory perception can be impaired in children with cerebral palsy (CP), the relationship between these two functions in this population is not clearly established. The common assumption that CP children with better sensory function also demonstrate better motor outcomes has been recently challenged. To study these questions further, we assessed both finger dexterity and finger gnosia, the ability to perceive one’s own fingers by touch, in groups of 11 children with unilateral (i.e., hemiplegic CP) and 11 children with bilateral spastic CP (i.e., diplegic CP) and compared them with typical children. In our sample, children with hemiplegia exhibited finger dexterity deficit in both hands and finger gnosia deficit only in their paretic hand. In contrast, children with diplegia exhibited finger gnosia deficits in both hands and finger dexterity deficit only in their dominant hand. Thus, our results indicated that children with spastic hemiplegia and diplegia present different sensory and motor profiles and suggest that these two subgroups of CP should be considered separately in future experimental and clinical research. We discuss the implications of our results for rehabilitation.
Collapse
Affiliation(s)
| | - Joel Fluss
- Pediatric Neurology Unit, Pediatric Subspecialties Service, Children’s Hospital of Geneva, Switzerland
| | | |
Collapse
|
11
|
Taylor S, McLean B, Blair E, Carey LM, Valentine J, Girdler S, Elliott C. Clinical acceptability of the sense_assess© kids
: Children and youth perspectives. Aust Occup Ther J 2017; 65:79-88. [DOI: 10.1111/1440-1630.12429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Susan Taylor
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
- Department of Paediatric Rehabilitation; Princess Margaret Hospital for Children; Perth WA Australia
| | - Belinda McLean
- Department of Paediatric Rehabilitation; Princess Margaret Hospital for Children; Perth WA Australia
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
| | - Eve Blair
- Population Sciences; Telethon Kids Institute; Perth WA Australia
| | - Leeanne Mary Carey
- Neurorehabilitation and Recovery; The Florey Institute of Neuroscience and Mental Health; Melbourne VIC Australia
- Occupational Therapy; School of Allied Health; La Trobe University; Melbourne VIC Australia
| | - Jane Valentine
- Department of Paediatric Rehabilitation; Princess Margaret Hospital for Children; Perth WA Australia
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
| | - Sonya Girdler
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
- Population Sciences; Telethon Kids Institute; Perth WA Australia
| | - Catherine Elliott
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
- Department of Paediatric Rehabilitation; Princess Margaret Hospital for Children; Perth WA Australia
| |
Collapse
|