1
|
Brown L, Goo M. Clinimetrics: Neurosensory Motor Developmental Assessment. J Physiother 2024; 70:240. [PMID: 38876945 DOI: 10.1016/j.jphys.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/20/2024] [Indexed: 06/16/2024] Open
Affiliation(s)
- Laura Brown
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Australia
| | - Miran Goo
- Department of Physical Therapy, School of Life and Health Sciences, Kyungsung University, South Korea
| |
Collapse
|
2
|
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
|
3
|
Liang KJ, Chen HL, Huang KL, Wang TM, Shieh JY, Wang TN. Assessment for Tactile Perception in Children With Cerebral Palsy. Am J Occup Ther 2023; 77:7704205050. [PMID: 37624995 DOI: 10.5014/ajot.2023.050106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
IMPORTANCE Impaired tactile perception frequently accompanies motor deficits in children with cerebral palsy (CP). Assessing tactile perception precisely for children with CP remains challenging because of a lack of assessments with robust psychometric evidence or standard procedures. OBJECTIVE To develop a standardized assessment tool, the Tactile Perceptual Test (TPT), for measuring tactile perception in children with CP and to examine its psychometric properties. DESIGN Observational study design. SETTING University research laboratory and medical center. PARTICIPANTS Children with CP (n = 100) and typical development (TD; n = 50). OUTCOMES AND MEASURES The TPT includes four subtests measuring stereognosis, roughness, hardness, and heaviness. Three comparator instruments, Semmes-Weinstein monofilaments, Two-Point Discrimination, and the stereognosis subtest of the Revised Nottingham Sensory Assessment, were used for convergent validity. RESULTS Good test-retest reliability was confirmed for all of the TPT subtests. The values of minimal detectable change were acceptable. Moderate correlations between the TPT and comparator instruments were found, as expected. For known-groups validity, the significant difference was confirmed between children with CP and those with TD. CONCLUSIONS AND RELEVANCE The TPT is a reliable and valid measure for multiple subdomains of tactile perception in children with CP. This tactile assessment may help clarify tactile performance to provide appropriate, precise interventions. What This Article Adds: The TPT measures tactile perception in children with CP. It has four subdomains of tactile perception that could facilitate prioritization of tactile treatment of specific subdomains and thereby aid in the provision of appropriate interventions.
Collapse
Affiliation(s)
- Kai-Jie Liang
- Kai-Jie Liang, PhD, is Postdoctoral Researcher, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan. At the time this article was submitted, Liang was PhD Student, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Hao-Ling Chen
- Hao-Ling Chen, PhD, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan
| | - Kuo-Lun Huang
- Kuo-Lun Huang, MS, is Occupational Therapist, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Ting-Ming Wang
- Ting-Ming Wang, MD, PhD, is Professor, Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei City, Taiwan, and Physician, Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei City, Taiwan
| | - Jeng-Yi Shieh
- Jeng-Yi Shieh, MD, is Physician, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan
| | - Tien-Ni Wang
- Tien-Ni Wang, PhD, is Professor, National Taiwan University, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan;
| |
Collapse
|
4
|
Ortega-Martínez A, Palomo-Carrión R, Varela-Ferro C, Bagur-Calafat MC. Feasibility of a Home-Based Mirror Therapy Program in Children with Unilateral Spastic Cerebral Palsy. Healthcare (Basel) 2023; 11:1797. [PMID: 37372915 DOI: 10.3390/healthcare11121797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/05/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Children with Unilateral Spastic Cerebral Palsy (US CP) have motor and somatosensory impairments that affect one side of their body, impacting upper limb functioning. These impairments contribute negatively to children's bimanual performance and quality of life. Intensive home-based therapies have been developed and have demonstrated their feasibility for children with US CP and their parents, especially when therapies are designed with the proper coaching of families. Mirror Therapy (MT) is being studied to become an approachable intensive and home-based therapy suitable for children with US CP. The aim of this study is to analyze the feasibility of a five-week home-based program of MT for children with US CP that includes coaching by the therapist. Six children aged 8-12 years old performed the therapy for five days per week, 30 min per day. A minimum of 80% of compliance was required. The feasibility included compliance evaluations, total dosage, perceived difficulty of the exercises, and losses of follow-ups. All children completed the therapy and were included in the analysis. The total accomplishment was 86.47 ± 7.67. The perceived difficulty of the exercises ranged from 2.37 to 4.51 out of 10. In conclusion, a home-based program of Mirror Therapy is a safe, cost-efficient, and feasible therapy for children with US CP when the therapist is involved as a coach during the entire program.
Collapse
Affiliation(s)
- Anna Ortega-Martínez
- Physiotherapy Department, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Physiotherapy Department, Fundació Aspace Catalunya, 08038 Barcelona, Spain
| | - Rocío Palomo-Carrión
- Physiotherapy Department, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
| | | | | |
Collapse
|
5
|
Hornsby EA, Tucker K, Johnston LM. Reproducibility of Hypermobility Assessment Scales for Children When Performed Using Telehealth versus In-Person Modes. Phys Occup Ther Pediatr 2022:1-17. [PMID: 36482699 DOI: 10.1080/01942638.2022.2151393] [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: 12/13/2022]
Abstract
AIMS Evaluate reproducibility of hypermobility assessments using in-person versus telehealth modes. METHODS Hypermobility of 20 children (7-12 years) was evaluated using the Beighton Score, Upper Limb Hypermobility Assessment Tool (ULHAT), and Lower Limb Assessment Score (LLAS) via in-person and telehealth modes. Agreement between the two modes was examined using percentage of exact agreement (%EA and %EA ± 2), Limits of Agreement (LoA) and Smallest detectable change (SDC). Reliability was calculated using intra-class correlation coefficients (ICCs). RESULTS Agreement between modes for total Scores was best for the Beighton (%EA = fair, %EA ± 2 = good), then the ULHAT (%EA = poor, %EA ± 2 = excellent), and LLAS (%EA = poor, %EA ± 2 = fair). Total scores for all scales showed wide LoA, large SDC (25-31%), and fair to good reliability (ICC = 0.54-0.61). Exact agreement for Generalized Joint Hypermobility classification was excellent for the Beighton (≥7/9 threshold) and fair for the ULHAT and LLAS (≥7/12 threshold). Percentage of individual test items with good/excellent agreement was highest for the Beighton (78%, 7/9 items), then the ULHAT (58%, 14/24) and LLAS (42%, 10/24). CONCLUSION Total Scores of hypermobility scales showed low exact agreement between in-person and telehealth, but fair-excellent agreement within two points. Classification using the Beighton ≥7/9 threshold was excellent. Research is recommended to increase accuracy of online assessments.
Collapse
Affiliation(s)
- Elizabeth A Hornsby
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Kids Care Physiotherapy, Brisbane, Australia
| | - Kylie Tucker
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
6
|
International Delphi Recommendations for Pediatric Lower Limb Neurological Test Protocols for Muscle Strength, Reflexes, and Tactile Sensitivity. Pediatr Phys Ther 2022; 34:497-506. [PMID: 35943387 DOI: 10.1097/pep.0000000000000946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To gain consensus from physical therapists on pediatric lower limb neurological tests of muscle strength, tactile sensitivity, and reflexes. METHODS A Delphi technique was used for 2 sequential questionnaire rounds to gain consensus from a panel of pediatric physical therapists (n = 28). Physical therapists rated their agreement to items from statements on pediatric lower limb neurological tests, their protocols, and interpretation using a 6-point Likert scale. RESULTS Ninety percent of items gained consensus: 80% on pediatric lower limb neurological tests, 88% on test protocols, and 92% on test interpretation. Fifty-one percent of items had high agreement and high importance. CONCLUSION There is variability in pediatric neurological tests used, their protocols, and interpretation. Identification of items with high agreement and importance is the first step to develop a standardized lower limb neurological assessment for pediatric clients of varying ages and diagnoses.
Collapse
|
7
|
Tran HT, Li YC, Lin HY, Lee SD, Wang PJ. Sensory Processing Impairments in Children with Developmental Coordination Disorder. CHILDREN 2022; 9:children9101443. [PMID: 36291382 PMCID: PMC9600147 DOI: 10.3390/children9101443] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022]
Abstract
The two objectives of this systematic review were to examine the following: (1) the difference in sensory processing areas (auditory, visual, vestibular, touch, proprioceptive, and multi-sensory) between children with and without developmental coordination disorder (DCD), and (2) the relationship between sensory processing and motor coordination in DCD. The following databases were comprehensively searched for relevant articles: PubMed, Science Direct, Web of Science, and Cochrane library. There were 1107 articles (published year = 2010 to 2021) found in the initial search. Full-text articles of all possibly relevant citations were obtained and inspected for suitability by two authors. The outcome measures were sensory processing impairments and their relationship with motor coordination. A total of 10 articles met the inclusion criteria. Children with DCD showed significant impairments in visual integration, tactile integration, proprioceptive integration, auditory integration, vestibular integration, and oral integration processes when compared with typically developing children. Evidence also supported that sensory processing impairments were associated with poor motor coordination in DCD. Preliminary support indicated that DCD have sensory processing impairments in visual, tactile, proprioceptive, auditory, and vestibular areas, which might contribute to participation restriction in motor activities. It is important to apply sensory integration therapy in rehabilitation programs for DCD in order to facilitate participation in daily activities.
Collapse
Affiliation(s)
- Huynh-Truc Tran
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan
| | - Yao-Chuen Li
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan
| | - Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung 41354, Taiwan
| | - Shin-Da Lee
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan
| | - Pei-Jung Wang
- Department of Physical Therapy, Asia University, Taichung 41354, Taiwan
- Correspondence: ; Tel.: +886-4-2332-3456 (ext. 48039)
| |
Collapse
|
8
|
Cemali M, Pekçetin S, Akı E. The Effectiveness of Sensory Integration Interventions on Motor and Sensory Functions in Infants with Cortical Vision Impairment and Cerebral Palsy: A Single Blind Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081123. [PMID: 36010014 PMCID: PMC9406788 DOI: 10.3390/children9081123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
Cortical vision impairment (CVI) and Cerebral Palsy (CP) lead to decrement in sensory and motor functions of infants. The current study examined the effectiveness of sensory integration interventions on sensory, motor, and oculomotor skills in infants with cortical vision impairment. Thirty-four infants with and CP aged 12−18 months were enrolled to the study. The infants were randomly divided into two groups as the control and intervention groups. The intervention group took sensory integration intervention 2 days a week for 8 weeks in addition to conventional physiotherapy 2 days a week for 8 weeks. The control group only received the conventional physiotherapy program 2 days a week for 8 weeks. The duration of the treatment sessions were 45 min for both interventions. Before and after the intervention, sensory processing functions were evaluated with the Test of Sensory Functions in Infants (TSFI), and motor functions were evaluated with the Alberta Infant Motor Scale (AIMS). There was a statistically significant difference between the pre- and post-test mean TSFI total and AIMS scores in the intervention group and control group (p < 0.001). The intervention group mean TSFI scores were more statistically significant than the those of the control group. Mean post-intervention AIMS scores did not differ between groups. Sensory integration intervention delivered with the conventional physiotherapy program was more effective than the conventional physiotherapy program in increasing sensory processing skills in one measure in infants with CVI and CP.
Collapse
Affiliation(s)
- Mustafa Cemali
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara 06050, Turkey;
- Correspondence:
| | - Serkan Pekçetin
- Department of Occupational Therapy, Faculty of Gülhane Health Sciences, University of Health Sciences Turkey, Ankara 06018, Turkey;
| | - Esra Akı
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara 06050, Turkey;
| |
Collapse
|
9
|
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
|
10
|
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] [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.govNCT02086214. 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
|
11
|
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
|
12
|
Araneda R, Sizonenko SV, Newman CJ, Dinomais M, Le Gal G, Ebner-Karestinos D, Paradis J, Klöcker A, Saussez G, Demas J, Bailly R, Bouvier S, Nowak E, Guzzetta A, Riquelme I, Brochard S, Bleyenheuft Y. Protocol of changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with bilateral cerebral palsy: a multisite randomized controlled trial. BMC Neurol 2020; 20:243. [PMID: 32532249 PMCID: PMC7291688 DOI: 10.1186/s12883-020-01820-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP), which is the leading cause of motor disability during childhood, can produce sensory and cognitive impairments at different degrees. Most recent therapeutic interventions for these patients have solely focused on upper extremities (UE), although more than 60% of these patients present lower extremities (LE) deficits. Recently, a new therapeutic concept, Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE), has been proposed, involving the constant stimulation of UE and LE. Based on motor skill learning principles, HABIT-ILE is delivered in a day-camp setting, promoting voluntary movements for several hours per day during 10 consecutive week days. Interestingly, the effects of this intervention in a large scale of youngsters are yet to be observed. This is of interest due to the lack of knowledge on functional, neuroplastic and biomechanical changes in infants with bilateral CP. The aim of this randomized controlled study is to assess the effects of HABIT-ILE adapted for pre-school children with bilateral CP regarding functional, neuroplastic and biomechanical factors. METHODS This international, multicentric study will include 50 pre-school children with CP from 12 to 60 months of age, comparing the effect of 50 h (2 weeks) of HABIT-ILE versus regular motor activity and/or customary rehabilitation. HABIT-ILE presents structured activities and functional tasks with continuous increase in difficulty while the child evolves. Assessments will be performed at 3 period times: baseline, two weeks later and 3 months later. The primary outcome will be the Gross Motor Function Measure 66. Secondary outcomes will include Both Hands Assessment, Melbourne Assessment-2, Semmes-Weinstein Monofilament Test, algometry assessments, executive function tests, ACTIVLIM-CP questionnaire, Pediatric Evaluation of Disability Inventory (computer adaptative test), Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, neuroimaging and kinematics. DISCUSSION The results of this study should highlight the impact of a motor, intensive, goal-directed therapy (HABIT-ILE) in pre-school children at a functional, neuroplastic and biomechanical level. In addition, this changes could demonstrated the impact of this intervention in the developmental curve of each child, improving functional ability, activity and participation in short-, mid- and long-term. NAME OF THE REGISTRY Evaluation of Functional, Neuroplastic and Biomechanical Changes Induced by an Intensive, Playful Early-morning Treatment Including Lower Limbs (EARLY-HABIT-ILE) in Preschool Children With Uni and Bilateral Cerebral Palsy (HABIT-ILE). TRIAL REGISTRATION NCT04017871 REGISTRATION DATE: July 12, 2019.
Collapse
Affiliation(s)
- Rodrigo Araneda
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Stephane V. Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Christopher J. Newman
- Paediatric Neurology and Neurorehabilitation Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - Mickael Dinomais
- Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, Angers, France
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Université d’Angers, Angers, France
| | - Gregoire Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Daniela Ebner-Karestinos
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Julie Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Anne Klöcker
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
- Haute Ecole Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Geoffroy Saussez
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Josselin Demas
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Université d’Angers, Angers, France
- Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation (IFM3R), Nantes, France
| | - Rodolphe Bailly
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Sandra Bouvier
- University Hospital of Brest, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Emmanuel Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Sylvain Brochard
- University Hospital of Brest, Brest, France
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| |
Collapse
|
13
|
Araneda R, Sizonenko SV, Newman CJ, Dinomais M, Le Gal G, Nowak E, Guzzetta A, Riquelme I, Brochard S, Bleyenheuft Y. Functional, neuroplastic and biomechanical changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with unilateral cerebral palsy: study protocol of a randomized control trial. BMC Neurol 2020; 20:133. [PMID: 32290815 PMCID: PMC7155331 DOI: 10.1186/s12883-020-01705-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP) causes motor, cognitive and sensory impairment at different extents. Many recent rehabilitation developments (therapies) have focused solely on the upper extremities (UE), although the lower extremities (LE) are commonly affected. Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) applies the concepts of motor skill learning and intensive training to both the UE and LE. It involves constant stimulation of the UE and LE, for several hours each day over a 2-week period. The effects of HABIT-ILE have never been evaluated in a large sample of young children. Furthermore, understanding of functional, neuroplastic and biomechanical changes in infants with CP is lacking. The aim of this study is to carry out a multi-center randomized controlled trial (RCT) to evaluate the effects of HABIT-ILE in pre-school children with unilateral CP on functional, neuroplastic and biomechanical parameters. METHODS This multi-center, 3-country study will include 50 pre-school children with CP aged 1-4 years. The RCT will compare the effect of 50 h (two weeks) of HABIT-ILE versus usual motor activity, including regular rehabilitation. HABIT-ILE will be delivered in a day-camp setting, with structured activities and functional tasks that will be continuously progressed in terms of difficulty. Assessments will be performed at 3 intervals: baseline (T0), two weeks later and 3 months later. Primary outcomes will be the Assisting Hand Assessment; secondary outcomes include the Melbourne Assessment-2, executive function assessments, questionnaires ACTIVLIM-CP, Pediatric Evaluation of Disability Inventory, Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, as well as neuroimaging and kinematics measures. DISCUSSION We expect that HABIT-ILE will induce functional, neuroplastic and biomechanical changes as a result of the intense, activity-based rehabilitation process and these changes will impact the whole developmental curve of each child, improving functional ability, activity and participation in the short-, mid- and long-term. Name of the registry: Changes Induced by Early HABIT-ILE in Pre-school Children With Uni- and Bilateral Cerebral Palsy (EarlyHABIT-ILE). TRIAL REGISTRATION Trial registration number: NCT04020354-Registration date on the International Clinical Trials Registry Platform (ICTRP): November 20th, 2018; Registration date on NIH Clinical Trials Registry: July 16th, 2019.
Collapse
Affiliation(s)
- R Araneda
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200, Brussels, Belgium
| | - S V Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - C J Newman
- Paediatric Neurology and Neurorehabilitation Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - M Dinomais
- CHU Angers, Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, Angers, France
- Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes, (LARIS) - EA7315, Angers, France
| | - G Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - E Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - A Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - S Brochard
- University Hospital of Brest, Brest, France
- Western Britany University, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
| | - Y Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200, Brussels, Belgium.
| |
Collapse
|
14
|
Simon-Martinez C, Mailleux L, Hoskens J, Ortibus E, Jaspers E, Wenderoth N, Sgandurra G, Cioni G, Molenaers G, Klingels K, Feys H. Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response. Ther Adv Neurol Disord 2020; 13:1756286419898065. [PMID: 32031542 PMCID: PMC6977217 DOI: 10.1177/1756286419898065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/09/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor
execution in unilateral cerebral palsy (uCP). As these children also show
motor planning deficits, action-observation training (AOT) might be of
additional value. Here, we investigated the combined effect of AOT to CIMT
and identified factors influencing treatment response. Methods: A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months)
participated in a 9-day camp wearing a splint for 6 h/day and were allocated
to the CIMT + AOT (n = 22) and the CIMT + placebo group
(n = 22). The CIMT + AOT group received 15 h of AOT
(i.e. video-observation) and executed the observed tasks, whilst the
CIMT + AOT group watched videos free of biological motion and executed the
same tasks. The primary outcome measure was bimanual performance. Secondary
outcomes included measures of body function and activity level assessed
before (T1), after the intervention (T2), and at 6 months follow-up (T3).
Influencing factors included behavioural and neurological
characteristics. Results: Although no between-groups differences were found
(p > 0.05; η2 = 0–16), the addition of AOT
led to higher gains in children with initially poorer bimanual performance
(p = 0.02; η2 = 0.14). Both groups improved
in all outcome measures after the intervention and retained the gains at
follow up (p < 0.01; η2 = 0.02–0.71). Poor
sensory function resulted in larger improvements in the total group
(p = 0.03; η2 = 0.25) and high amounts of
mirror movements tended to result in a better response to the additional AOT
training (p = 0.06; η2 = 0.18). Improvements
were similar irrespective of the type of brain lesion or corticospinal tract
wiring pattern. Conclusions: Adding AOT to CIMT, resulted in a better outcome for children with poor motor
function and high amounts of mirror movements. CIMT with or without AOT
seems to be more beneficial for children with poor sensory function. Trial registration: Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov
identifier: NCT03256357).
Collapse
Affiliation(s)
- Cristina Simon-Martinez
- KU Leuven, Department of Rehabilitation Sciences, Herestraat 49, bus 1510, Leuven, 3000, Belgium
| | - Lisa Mailleux
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Jasmine Hoskens
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Els Ortibus
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
| | - Guy Molenaers
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Katrijn Klingels
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Hilde Feys
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| |
Collapse
|
15
|
Dewar R, Claus AP, Tucker K, Ware RS, Johnston LM. Reproducibility of the Kids-BESTest and the Kids-Mini-BESTest for Children With Cerebral Palsy. Arch Phys Med Rehabil 2019; 100:695-702. [DOI: 10.1016/j.apmr.2018.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/28/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
|
16
|
Zarkou A, Lee SCK, Prosser LA, Hwang S, Jeka J. Stochastic resonance stimulation improves balance in children with cerebral palsy: a case control study. J Neuroeng Rehabil 2018; 15:115. [PMID: 30526617 PMCID: PMC6288963 DOI: 10.1186/s12984-018-0467-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background Stochastic Resonance (SR) Stimulation has been used to enhance balance in populations with sensory deficits by improving the detection and transmission of afferent information. Despite the potential promise of SR in improving postural control, its use in individuals with cerebral palsy (CP) is novel. The objective of this study was to investigate the immediate effects of electrical SR stimulation when applied in the ankle muscles and ligaments on postural stability in children with CP and their typically developing (TD) peers. Methods Ten children with spastic diplegia (GMFCS level I- III) and ten age-matched TD children participated in this study. For each participant the SR sensory threshold was determined. Then, five different SR intensity levels (no stimulation, 25, 50, 75, and 90% of sensory threshold) were used to identify the optimal SR intensity for each subject. The optimal SR and no stimulation condition were tested while children stood on top of 2 force plates with their eyes open and closed. To assess balance, the center of pressure velocity (COPV) in anteroposterior (A/P) and medial-lateral (M/L) direction, 95% COP confidence ellipse area (COPA), and A/P and M/L root mean square (RMS) measures were computed and compared. Results For the CP group, SR significantly decreased COPV in A/P direction, and COPA measures compared to the no stimulation condition for the eyes open condition. In the eyes closed condition, SR significantly decreased COPV only in M/L direction. Children with CP demonstrated greater reduction in all the COP measures but the RMS in M/L direction during the eyes open condition compared to their TD peers. The only significant difference between groups in the eyes closed condition was in the COPV in M/L direction. Conclusions SR electrical stimulation may be an effective stimulation approach for decreasing postural sway and has the potential to be used as a therapeutic tool to improve balance. Applying subject-specific SR stimulation intensities is recommended to maximize balance improvements. Overall, balance rehabilitation interventions in CP might be more effective if sensory facilitation methods, like SR, are utilized by the clinicians. Trial registration ClinicalTrials.gov identifier NCT02456376; 28 May 2015 (Retrospectively registered); https://clinicaltrials.gov/ct2/show/NCT02456376.
Collapse
Affiliation(s)
- Anastasia Zarkou
- Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, 2020 Peachtree Rd NW, Atlanta, GA, 30309, USA.
| | - Samuel C K Lee
- Program in Biomechanics and Movement Science & Department of Physical Therapy, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA.,Shriners Hospital for Children, 3551 North Broad Street, Philadelphia, PA, 19140, USA
| | - Laura A Prosser
- University of Pennsylvania & The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Sungjae Hwang
- Department of Kinesiology, University of Maryland Eastern Shore, William P. Hytche Center Room 1124, Princess Anne, MD, 21853, USA
| | - John Jeka
- Department of Kinesiology, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA
| |
Collapse
|
17
|
Somatosensory Plasticity in Pediatric Cerebral Palsy following Constraint-Induced Movement Therapy. Neural Plast 2018; 2018:1891978. [PMID: 30532772 PMCID: PMC6250030 DOI: 10.1155/2018/1891978] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/16/2018] [Indexed: 01/15/2023] Open
Abstract
Cerebral palsy (CP) is predominantly a disorder of movement, with evidence of sensory-motor dysfunction. CIMT1 is a widely used treatment for hemiplegic CP. However, effects of CIMT on somatosensory processing remain unclear. To examine potential CIMT-induced changes in cortical tactile processing, we designed a prospective study, during which 10 children with hemiplegic CP (5 to 8 years old) underwent an intensive one-week-long nonremovable hard-constraint CIMT. Before and directly after the treatment, we recorded their cortical event-related potential (ERP) responses to calibrated light touch (versus a control stimulus) at the more and less affected hand. To provide insights into the core neurophysiological deficits in light touch processing in CP as well as into the plasticity of this function following CIMT, we analyzed the ERPs within an electrical neuroimaging framework. After CIMT, brain areas governing the more affected hand responded to touch in configurations similar to those activated by the hemisphere controlling the less affected hand before CIMT. This was in contrast to the affected hand where configurations resembled those of the more affected hand before CIMT. Furthermore, dysfunctional patterns of brain activity, identified using hierarchical ERP cluster analyses, appeared reduced after CIMT in proportion with changes in sensory-motor measures (grip or pinch movements). These novel results suggest recovery of functional sensory activation as one possible mechanism underlying the effectiveness of intensive constraint-based therapy on motor functions in the more affected upper extremity in CP. However, maladaptive effects on the less affected constrained extremity may also have occurred. Our findings also highlight the use of electrical neuroimaging as feasible methodology to measure changes in tactile function after treatment even in young children, as it does not require active participation.
Collapse
|
18
|
Abstract
There are many nonsurgical treatment options for patients with upper limb spasticity. This article presents an algorithmic approach to management, encompassing evidence-based rehabilitation therapies, medications, and promising new orthotic and robotic innovations.
Collapse
Affiliation(s)
- Laura Black
- Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, 355 East Erie Street, 21st Floor, Suite 2127, Chicago, IL 60601, USA.
| | - Deborah Gaebler-Spira
- Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, 355 East Erie Street, Chicago, IL 60601, USA
| |
Collapse
|
19
|
Corticospinal Tract Wiring and Brain Lesion Characteristics in Unilateral Cerebral Palsy: Determinants of Upper Limb Motor and Sensory Function. Neural Plast 2018; 2018:2671613. [PMID: 30344602 PMCID: PMC6158964 DOI: 10.1155/2018/2671613] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/18/2018] [Accepted: 08/05/2018] [Indexed: 11/17/2022] Open
Abstract
Brain lesion characteristics (timing, location, and extent) and the type of corticospinal tract (CST) wiring have been proposed as determinants of upper limb (UL) motor function in unilateral cerebral palsy (uCP), yet an investigation of the relative combined impact of these factors on both motor and sensory functions is still lacking. Here, we first investigated whether structural brain lesion characteristics could predict the underlying CST wiring and we explored the role of CST wiring and brain lesion characteristics to predict UL motor and sensory functions in uCP. Fifty-two participants with uCP (mean age (SD): 11 y and 3 m (3 y and 10 m)) underwent a single-pulse Transcranial Magnetic Stimulation session to determine CST wiring between the motor cortex and the more affected hand (n = 17 contralateral, n = 19 ipsilateral, and n = 16 bilateral) and an MRI to determine lesion timing (n = 34 periventricular (PV) lesion, n = 18 corticosubcortical (CSC) lesion), location, and extent. Lesion location and extent were evaluated with a semiquantitative scale. A standardized protocol included UL motor (grip strength, unimanual capacity, and bimanual performance) and sensory measures. A combination of lesion locations (damage to the PLIC and frontal lobe) significantly contributed to differentiate between the CST wiring groups, reclassifying the participants in their original group with 57% of accuracy. Motor and sensory functions were influenced by each of the investigated neurological factors. However, multiple regression analyses showed that motor function was predicted by the CST wiring (more preserved in individuals with contralateral CST (p < 0.01)), lesion extent, and damage to the basal ganglia and thalamus. Sensory function was predicted by the combination of a large and later lesion and an ipsilateral or bilateral CST wiring, which led to increased sensory deficits (p < 0.05). These novel insights contribute to a better understanding of the underlying pathophysiology of UL function and may be useful to delineate individualized treatment strategies.
Collapse
|
20
|
Taylor S, Girdler S, Parsons R, McLean B, Falkmer T, Carey L, Blair E, Elliott C. Construct validity and responsiveness of the functional Tactile Object Recognition Test for children with cerebral palsy. Aust Occup Ther J 2018; 65:420-430. [DOI: 10.1111/1440-1630.12508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Susan Taylor
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
- Paediatric Rehabilitation (Kids Rehab WA); Perth Children's Hospital; Perth Western Australia Australia
| | - Sonya Girdler
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
- Population Sciences; Telethon Kids Institute; Perth Western Australia Australia
| | - Richard Parsons
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
| | - Belinda McLean
- School of Paediatrics and Child Health; University of Western Australia; Perth Western Australia Australia
- Paediatric Rehabilitation (Kids Rehab WA); Perth Children's Hospital; Perth Western Australia Australia
| | - Torbjorn Falkmer
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
| | - Leeanne Carey
- Neurorehabilitation and Recovery; The Florey Institute of Neuroscience and Mental Health; Melbourne Victoria Australia
- Occupational Therapy; School of Allied Health; La Trobe University; Melbourne Victoria Australia
| | - Eve Blair
- Population Sciences; Telethon Kids Institute; Perth Western Australia Australia
| | - Catherine Elliott
- School of Occupational Therapy and Social Work; Curtin University; Perth WA Australia
- Paediatric Rehabilitation (Kids Rehab WA); Perth Children's Hospital; Perth Western Australia Australia
| |
Collapse
|
21
|
Simon-Martinez C, Mailleux L, Ortibus E, Fehrenbach A, Sgandurra G, Cioni G, Desloovere K, Wenderoth N, Demaerel P, Sunaert S, Molenaers G, Feys H, Klingels K. Combining constraint-induced movement therapy and action-observation training in children with unilateral cerebral palsy: a randomized controlled trial. BMC Pediatr 2018; 18:250. [PMID: 30064396 PMCID: PMC6069849 DOI: 10.1186/s12887-018-1228-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/19/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Upper limb (UL) deficits in children with unilateral cerebral palsy (uCP) have traditionally been targeted with motor execution treatment models, such as modified Constraint-Induced Movement Therapy (mCIMT). However, new approaches based on a neurophysiological model such as Action-Observation Training (AOT) may provide new opportunities for enhanced motor learning. The aim of this study is to describe a randomised controlled trial (RCT) protocol investigating the effects of an intensive treatment model, combining mCIMT and AOT compared to mCIMT alone on UL function in children with uCP. Additionally, the role of neurological factors as potential biomarkers of treatment response will be analysed. METHODS An evaluator-blinded RCT will be conducted in 42 children aged between 6 and 12 years. Before randomization, children will be stratified according to their House Functional Classification Scale, age and type of corticospinal tract wiring. A 2-week day-camp will be set up in which children receive intensive mCIMT therapy for 6 hours a day on 9 out of 11 consecutive days (54 h) including AOT or control condition (15 h). During AOT, these children watch video sequences showing goal-directed actions and subsequently execute the observed actions with the more impaired UL. The control group performs the same actions after watching computer games without human motion. The primary outcome measure will be the Assisting Hand Assessment. Secondary outcomes comprise clinical assessments across body function, activity and participation level of the International Classification of Function, Disability and Health. Furthermore, to quantitatively evaluate UL movement patterns, a three-dimensional motion analysis will be conducted. UL function will be assessed at baseline, immediately before and after intervention and at 6 months follow up. Brain imaging comprising structural and functional connectivity measures as well as Transcranial Magnetic Stimulation (TMS) to evaluate corticospinal tract wiring will be acquired before the intervention. DISCUSSION This paper describes the methodology of an RCT with two main objectives: (1) to evaluate the added value of AOT to mCIMT on UL outcome in children with uCP and (2) to investigate the role of neurological factors as potential biomarkers of treatment response. TRIAL REGISTRATION NCT03256357 registered on 21st August 2017 (retrospectively registered).
Collapse
Affiliation(s)
| | - Lisa Mailleux
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Anna Fehrenbach
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | - Philippe Demaerel
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Guy Molenaers
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Rehabilitation Research Centre, BIOMED, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
22
|
Taylor S, McLean B, Falkmer T, Carey LM, Girdler S, Elliott C, Blair E. Assessing body sensations in children: Intra-rater reliability of assessment and effects of age. Br J Occup Ther 2018. [DOI: 10.1177/0308022618786933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction This article examines the effect of age and gender on somatosensory capacity for children and adolescents, and provides preliminary normative data and reliability for the SenScreen© Kids, a new standardised measure of touch, wrist position sense and haptic object recognition. Method A cross-sectional study of 88 typically developing children aged 6–15 years (mean 10.3 years; SD 2.6 years) was used to determine the developmental effects of age and gender on somatosensory capacity. Intra-rater reliability was assessed in 22 of the 88 participants at two time points (mean 8.8 years; SD 2.6 years). Results Statistically significant differences were observed between age groups for tactile discrimination, wrist position sense and haptic object recognition, but not for touch registration for which all except one participant achieved a maximum score. There was no effect of gender. Three of four SenScreen Kids subtests demonstrated good intra-rater agreement between time points. Conclusions Somatosensory capacity increased with age for typically developing children aged 6–15 years. Three subtests of the SenScreen Kids demonstrated good intra-rater reliability with typically developing children. Further investigation of reliability is required, and all subtests require psychometric testing with clinical populations.
Collapse
Affiliation(s)
- Susan Taylor
- Sessional academic, Senior occupational therapist, School of Occupational Therapy and Social Work, Curtin University, Australia; PhD candidate, Department of Paediatric Rehabilitation, Perth Children's Hospital, Australia
| | - Belinda McLean
- PhD candidate, Senior occupational therapist, School of Paediatrics and Child Health, University of Western Australia, Australia; Research associate, Department of Paediatric Rehabilitation, Perth Children's Hospital, Australia
| | - Torbjorn Falkmer
- Dean of Research at the Faculty of Health Sciences, School of Occupational Therapy and Social Work, Curtin University, Australia
| | - Leeanne M Carey
- Professor in Occupational Therapy – Discipline Lead, School of Allied Health, La Trobe University, Australia; Founding Head, Neurorehabilitation and Recovery, The Florey Institute of Neuroscience and Mental Health, Australia
| | - Sonya Girdler
- Professor at the Faculty of Health Sciences, School of Occupational Therapy and Social Work, Curtin University, Australia; Research associate, Population Sciences, Telethon Kids Institute, Australia
| | - Catherine Elliott
- Chair of Kids Rehab Western Australia, Department of Paediatric Rehabilitation, Perth Children's Hospital, Australia; Professor, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Eve Blair
- Adjunct Associate Professor, Population Sciences, Telethon Kids Institute, Australia
| |
Collapse
|
23
|
Garzon LC, Switzer L, Musselman KE, Fehlings D. The use of functional electrical stimulation to improve upper limb function in children with hemiplegic cerebral palsy: A feasibility study. J Rehabil Assist Technol Eng 2018; 5:2055668318768402. [PMID: 31191936 PMCID: PMC6453088 DOI: 10.1177/2055668318768402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/28/2018] [Indexed: 11/17/2022] Open
Abstract
Background Grasping and manipulating objects are common problems for children with
hemiplegic cerebral palsy. Multichannel-functional electrical stimulation
may help facilitate upper limb movements and improve function. Objective To evaluate the feasibility of multichannel-functional electrical stimulation
to improve grasp and upper limb function in children with hemiplegic
cerebral palsy to inform the development of a clinical trial. Methods A prospective pre-/post-test/follow-up (six months) design with three
children, aged 6–13 years, was used. Multichannel-functional electrical
stimulation (mFES) was applied to the hemiplegic upper limb for up to 48
sessions over 16 weeks. Feasibility indicators included recruitment of
participants and adherence rates, safety, and discomfort/pain. Effectiveness
was assessed using the grasp domain of the Quality of Upper Extremity Skills
Test, and other secondary clinical outcome measures with “success” criteria
set a priori. Results Participant recruitment target was not met but adherence was high, and
multichannel-functional electrical stimulation was found to be safe and
comfortable. Of the three participants, two improved in grasp at post-test,
whereas one child’s ability deteriorated. Only one child met success
criteria on most outcomes at post-test. Conclusions Feasibility indicators met success criteria, except for participant
recruitment. Treatment effectiveness was mixed. A future case comparison
investigation with a larger but more selected sample is suggested.
Collapse
Affiliation(s)
- Luisa C Garzon
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,2Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Canada
| | - Lauren Switzer
- 2Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Canada
| | - Kristin E Musselman
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Darcy Fehlings
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,2Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| |
Collapse
|
24
|
Auld ML, Johnston LM. Getting inTOUCH: outcomes of a knowledge translation intervention for tactile assessment knowledge, barriers, and practice in paediatric therapists working with children with cerebral palsy. Disabil Rehabil 2018; 41:2350-2358. [PMID: 29693473 DOI: 10.1080/09638288.2018.1466202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: Tactile impairments are common in children with cerebral palsy (CP), however assessment is not routinely carried out by therapists. We investigated a multi-faceted Knowledge Translation intervention to improve Knowledge, remove Barriers and enhance Practice of tactile assessments by paediatric therapists. Method: Twelve therapists from a state-wide service for children with CP (seven physiotherapists, five occupational therapists; 12 female) received: written information, demonstration videos, a face-to-face workshop, equipment provision, and on-call mentoring. Therapists completed pre-post-intervention questionnaires reporting their perceived tactile assessment Knowledge, current Practices and implementation Barriers. Results: Following intervention, therapists improved Knowledge of correct (1) tactile impairment prevalence in children with CP (pre 3/12; post 9/12), (2) tactile assessment items (e.g. Registration - pre 1/12; post 9/12; Localisation - pre 2/12; post 10/12), and (3) equipment choice (e.g. Monofilaments - pre 1/12; post 10/12). Tactile assessment Practice improved slightly. All major clinician-level implementation Barriers were resolved and less obvious organisational-level Barriers were identified for follow-up. Conclusion: A 12-month multi-faceted Knowledge Translation intervention can improve tactile assessment Knowledge, resolve major clinician-level implementation Barriers, and identify less obvious organisational-level Barriers to be addressed to achieve maximum Practice improvement. Ongoing multi-faceted knowledge translation processes are essential for high-performing organisations. Implications for rehabilitation A multi-faceted knowledge translation intervention significantly improved paediatric therapists' knowledge of the items and equipment necessary for tactile assessment. A 12-month intervention can address clinician-level barriers of knowledge, confidence, and access to equipment and assist in the identification of less obvious organisational-level barriers. Consideration of motivational readiness for change, intervention timelines, monitoring of emergent barriers, and fitting tactile assessment into a broader assessment framework are critical for improving uptake of tactile assessment in practice.
Collapse
Affiliation(s)
- Megan L Auld
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.,b CPL - Choice, Passion, Life , Brisbane , Australia
| | - Leanne M Johnston
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
| |
Collapse
|
25
|
Evaluation of the graded redefined assessment of strength, sensibility and prehension (GRASSP) in children with tetraplegia. Spinal Cord 2018; 56:741-749. [DOI: 10.1038/s41393-018-0084-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/17/2018] [Indexed: 11/08/2022]
|
26
|
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
|
27
|
Walmsley C, Taylor S, Parkins T, Carey L, Girdler S, Elliott C. What is the current practice of therapists in the measurement of somatosensation in children with cerebral palsy and other neurological disorders? Aust Occup Ther J 2017; 65:89-97. [DOI: 10.1111/1440-1630.12431] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Corrin Walmsley
- School of Occupational Therapy and Social Work; Curtin University; Perth Australia
| | - Susan Taylor
- School of Occupational Therapy and Social Work; Curtin University; Perth Australia
- Department of Paediatric Rehabilitation; Princess Margaret Hospital for Children; Perth Australia
| | - Timothy Parkins
- School of Occupational Therapy and Social Work; Curtin University; Perth Australia
| | - Leeanne Carey
- Neurorehabilitation and Recovery; The Florey Institute of Neuroscience and Mental Health; Melbourne Australia
- Occupational Therapy; School of Allied Health; La Trobe University; Melbourne Australia
| | - Sonya Girdler
- School of Occupational Therapy and Social Work; Curtin University; Perth Australia
| | - Catherine Elliott
- School of Occupational Therapy and Social Work; Curtin University; Perth Australia
| |
Collapse
|
28
|
Jafari N, Adams K, Tavakoli M, Wiebe S, Janz H. Usability testing of a developed assistive robotic system with virtual assistance for individuals with cerebral palsy: a case study. Disabil Rehabil Assist Technol 2017; 13:517-522. [PMID: 28673115 DOI: 10.1080/17483107.2017.1344884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This paper presents a novel application of an assistive robotic system with virtual assistance to enhance manual performance of individuals with cerebral palsy. Cerebral palsy affects one's voluntary motor movements resulting in limited opportunities to actively engage in physical manipulative activities that require fine motor movements and coordination. Lack of object manipulation and environmental exploration can result in further impairments such as cognitive and social delays. The proposed assistive robotic system has been developed to enhance hand movements of people with disabilities when performing a functional task colouring. This paper presents the usability testing of the effectiveness of the developed system with an individual with cerebral palsy in a set of colouring tasks. Assisted and unassisted approaches were compared and analysed through quantitative and qualitative measures. The robotic-based approach was further compared with the participant's typical alternate access method to perform the same proposed tasks. The robotic system with virtual assistance was clinically validated to be significantly more effective, compared to both unassisted and typical approaches, by increasing the hand controllability, reducing the physical load and increasing the easiness of maintaining movements within the lines. Future studies will inform the use of the system for children with disabilities to provide them with assisted play for functional and playful activities. Implications for rehabilitation Robotic system can enhance manual performance in individuals with disabilities. Participating in a robot-mediated play activity could increase children's motivation and engagement. The developed robotic system can contribute to a basis for clinical and home-based implementation of the technology to promote manual play activities for children with disabilities.
Collapse
Affiliation(s)
- Nooshin Jafari
- a Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Canada
| | - Kim Adams
- a Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Canada.,b Aleksandar Kostov Assistive Technology Laboratory, Glenrose Rehabilitation Hospital , Edmonton , Canada
| | - Mahdi Tavakoli
- c Department of Electrical and Computer Engineering , University of Alberta , Edmonton , Canada
| | - Sandra Wiebe
- d Department of Psychology , University of Alberta , Edmonton , Canada
| | - Heidi Janz
- a Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Canada
| |
Collapse
|
29
|
Dewar R, Claus AP, Tucker K, Ware R, Johnston LM. Reproducibility of the Balance Evaluation Systems Test (BESTest) and the Mini-BESTest in school-aged children. Gait Posture 2017; 55:68-74. [PMID: 28419876 DOI: 10.1016/j.gaitpost.2017.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 02/02/2023]
Abstract
This study evaluated the intra-rater, inter-rater and test-retest reproducibility of the Full-BESTest and Mini-BESTest when assessing postural control in children. Thirty-four children aged 7-17 years participated in intra-rater and inter-rater evaluation, and 22 children repeated assessment six weeks later for evaluation of test-retest reliability. Postural control was assessed using the Full Balance Evaluation Systems Test (Full-BESTest) and the short-form Mini-BESTest. Intra-rater, inter-rater and test-retest reproducibility were examined using video assessment. Test-retest reproducibility was also assessed in real-time. Reproducibility was examined by agreement and reliability statistics. Agreement was calculated using percentage of agreement, Limits of Agreement and Smallest Detectable Change. Reliability was calculated using Intra-class Correlation Coefficients. Results showed that the reliability of Total Scores was excellent for the Full-BESTest for all conditions (all ICCs>0.82), whereas the Mini-BESTest ranged from fair to excellent (ICC=0.56-0.86). Percentage of Domain Scores with good-excellent reliability (ICCs>0.60) was slightly higher for the Full-BESTest (66%) compared to the Mini-BESTest (59%). Smallest Detectable Change scores were good to excellent for the Full-BESTest (2%-6%) and for the Mini-BESTest (5%-10%) relative to total test scores. Both the Full-BESTest and Mini-BESTest can discriminate postural control abilities within and between days in school-aged children. The Full-BESTest has slightly better reproducibility and a broader range of items, which could be the most useful version for treatment planning. We propose minor modifications to improve reproducibility for children, and indicate the modified version by the title Kids-BESTest. Future psychometric research is recommended for specific paediatric clinical populations.
Collapse
Affiliation(s)
- R Dewar
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia.
| | - A P Claus
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - K Tucker
- The University of Queensland, School of Biomedical Sciences, Brisbane, Australia
| | - R Ware
- Griffith University, Menzies Health Institute Queensland, Australia; The University of Queensland, Queensland Centre for Intellectual and Developmental Disability, Brisbane, Australia
| | - L M Johnston
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| |
Collapse
|
30
|
Auld ML, Johnston LM. Perspectives on tactile intervention for children with cerebral palsy: a framework to guide clinical reasoning and future research. Disabil Rehabil 2017; 40:1849-1854. [DOI: 10.1080/09638288.2017.1312571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Megan L. Auld
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Cerebral Palsy League, Brisbane, Australia
| | - Leanne M. Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
31
|
Auld ML, Johnston LM. A touchy topic: tactile assessment among pediatric therapists. Disabil Rehabil 2016; 40:267-276. [DOI: 10.1080/09638288.2016.1250170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Megan Louise Auld
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Cerebral Palsy League, Brisbane, Australia
| | - Leanne Marie Johnston
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
32
|
Taylor S, McLean B, Falkmer T, Carey L, Girdler S, Elliott C, Blair E. Does somatosensation change with age in children and adolescents? A systematic review. Child Care Health Dev 2016; 42:809-824. [PMID: 27470009 DOI: 10.1111/cch.12375] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 06/01/2016] [Accepted: 06/11/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Somatosensory modalities, such as touch, proprioception and haptic ability, greatly influence the achievement of developmental milestones for children. Describing somatosensory impairment, natural variability and typical or expected developmental changes across age groups will help establish frameworks for intervention in clinical populations. This systematic review aimed to determine how different somatosensory modalities develop across childhood into adolescence to use as a point of reference for children at risk of somatosensory impairment. METHODS Searches of five electronic databases were undertaken through EBSCO-host (MEDLINE, CINAHL, PsycINFO, SPORTDiscus and ERIC) for studies measuring at least one somatosensory modality in typically developing individuals between birth and 18 years and analysed by age. Characteristics of studies were collected including country of origin, sample size, demographics and outcome measure used. Quality assessment and data extraction were performed by two independent reviewers. RESULTS Twenty three cross-sectional studies were included from a total of 188 articles retrieved: 8 examined aspects of touch, 5 proprioception and 10 haptic ability. Variability of study designs and variation in assessment tools precluded any formal meta-analysis. CONCLUSIONS Somatosensation matures through childhood into adolescence; however, the present review found the pattern of somatosensory development varied depending on the assessment tool used and the aspect of somatosensation being measured, making it difficult to describe typical performance. There is a need for comprehensive assessment batteries to measure the somatosensation, including touch, proprioception and haptic ability, of children at risk of somatosensory impairment to aid in the development of effective interventions.
Collapse
Affiliation(s)
- S Taylor
- Faculty of Computing Health and Science, Edith Cowan University, Perth, Australia. .,School of Occupational Therapy and Social work, Curtin University, Perth, Australia. .,Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Australia.
| | - B McLean
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Australia
| | - T Falkmer
- School of Occupational Therapy and Social work, Curtin University, Perth, Australia
| | - L Carey
- Neurorehabilitation and Recovery, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.,Occupational Therapy, School of Allied Health, La Trobe University, Melbourne, Australia
| | - S Girdler
- School of Occupational Therapy and Social work, Curtin University, Perth, Australia.,Population Sciences, Telethon Kids Institute, Perth, Australia
| | - C Elliott
- School of Occupational Therapy and Social work, Curtin University, Perth, Australia.,Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Australia
| | - E Blair
- Population Sciences, Telethon Kids Institute, Perth, Australia
| |
Collapse
|
33
|
Auld ML, Johnston LM, Russo RN, Moseley GL. A Single Session of Mirror-based Tactile and Motor Training Improves Tactile Dysfunction in Children with Unilateral Cerebral Palsy: A Replicated Randomized Controlled Case Series. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2016; 22. [DOI: 10.1002/pri.1674] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/10/2016] [Accepted: 06/04/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Megan L. Auld
- Cerebral Palsy League; Brisbane Australia
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Australia
| | - Leanne M. Johnston
- Cerebral Palsy League; Brisbane Australia
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Australia
| | - Remo N. Russo
- Paediatric Rehabilitation Department; Women's and Children's Hospital Campus; Adelaide Australia
- The Flinders University School of Medicine; Bedford Park Australia
| | - G. Lorimer Moseley
- Sansom Institute for Health Research; University of South Australia; Adelaide Australia
| |
Collapse
|
34
|
Zielinski IM, Steenbergen B, Baas CM, Aarts P, Jongsma MLA. Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy. J Vis Exp 2016. [PMID: 26780483 PMCID: PMC4781417 DOI: 10.3791/53420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Unilateral Cerebral Palsy (CP) is a neurodevelopmental disorder that is a very common cause of disability in childhood. It is characterized by unilateral motor impairments that are frequently dominated in the upper limb. In addition to a reduced movement capacity of the affected upper limb, several children with unilateral CP show a reduced awareness of the remaining movement capacity of that limb. This phenomenon of disregarding the preserved capacity of the affected upper limb is regularly referred to as Developmental Disregard (DD). Different theories have been postulated to explain DD, each suggesting slightly different guidelines for therapy. Still, cognitive processes that might additionally contribute to DD in children with unilateral CP have never been directly studied. The current protocol was developed to study cognitive aspects involved in upper limb control in children with unilateral CP with and without DD. This was done by recording event-related potentials (ERPs) extracted from the ongoing EEG during target-response tasks asking for a hand-movement response. ERPs consist of several components, each of them associated with a well-defined cognitive process (e.g., the N1 with early attention processes, the N2 with cognitive control and the P3 with cognitive load and mental effort). Due to its excellent temporal resolution, the ERP technique enables to study several covert cognitive processes preceding overt motor responses and thus allows insight into the cognitive processes that might contribute to the phenomenon of DD. Using this protocol adds a new level of explanation to existing behavioral studies and opens new avenues to the broader implementation of research on cognitive aspects of developmental movement restrictions in children.
Collapse
Affiliation(s)
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen; School of Psychology, Australian Catholic University
| | | | - Pauline Aarts
- Department of Pediatric Rehabilitation, Sint Maartenskliniek
| | | |
Collapse
|
35
|
Chorna O, Heathcock J, Key A, Noritz G, Carey H, Hamm E, Nelin MA, Murray M, Needham A, Slaughter JC, Maitre NL. Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: a randomised clinical trial protocol. BMJ Open 2015; 5:e010212. [PMID: 26644127 PMCID: PMC4679990 DOI: 10.1136/bmjopen-2015-010212] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Cerebral palsy (CP) is the most common physical disability in childhood. It is a disorder resulting from sensory and motor impairments due to perinatal brain injury, with lifetime consequences that range from poor adaptive and social function to communication and emotional disturbances. Infants with CP have a fundamental disadvantage in recovering motor function: they do not receive accurate sensory feedback from their movements, leading to developmental disregard. Constraint-induced movement therapy (CIMT) is one of the few effective neurorehabilitative strategies shown to improve upper extremity motor function in adults and older children with CP, potentially overcoming developmental disregard. METHODS AND ANALYSIS This study is a randomised controlled trial of children 12-24 months corrected age studying the effectiveness of CIMT combined with motor and sensory-motor interventions. The study population will comprise 72 children with CP and 144 typically developing children for a total of N=216 children. All children with CP, regardless of group allocation will continue with their standard of care occupational and physical therapy throughout the study. The research material collected will be in the form of data from high-density array event-related potential scan, standardised assessment scores and motion analysis scores. ETHICS AND DISSEMINATION The study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT02567630.
Collapse
Affiliation(s)
- Olena Chorna
- The Perinatal Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jill Heathcock
- Department of Allied Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Alexandra Key
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Garey Noritz
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Helen Carey
- The Perinatal Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ellyn Hamm
- The Perinatal Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Mary Ann Nelin
- The Perinatal Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Micah Murray
- Department of Clinical Neurosciences and Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Amy Needham
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nathalie L Maitre
- The Perinatal Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| |
Collapse
|
36
|
Cox LE, Harris EC, Auld ML, Johnston LM. Impact of tactile function on upper limb motor function in children with Developmental Coordination Disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 45-46:373-383. [PMID: 26299639 DOI: 10.1016/j.ridd.2015.07.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 06/13/2015] [Accepted: 07/30/2015] [Indexed: 06/04/2023]
Abstract
This study investigated the presence of, and relationship between tactile dysfunction and upper limb motor function in children with Developmental Coordination Disorder (DCD) compared to typical developing (TD) children. Participants were 36 children aged 6-12 years. Presence of DCD (n=20) or TD (n=16) was confirmed using the Movement Assessment Battery for Children, second edition. All children participated in a comprehensive assessment of tactile registration (Semmes Weinstein Monofilaments); tactile spatial perception (Single Point Localisation (SPL) and two-point discrimination (2PD)); haptic perception (Stereognosis); speed of simple everyday manual tasks (Jebsen-Taylor Test of Hand Function (JTTHF)); and handwriting speed and accuracy (Evaluation Tool of Children's Handwriting (ETCH)). Compared to TD children, children with DCD demonstrated poorer localisation of touch in the non-dominant hand (p=0.04), slower speed of alphabet writing (p<0.05) and less legible handwriting (p<0.01), but no difference in speed of simple everyday manual tasks (JTTHF: p>0.05). Regression analysis showed that spatial tactile perception (SPL) predicted handwriting legibility (ETCH: r=0.11) and speed of functional tasks (JTTHF: r=0.33). These results suggest that tactile function, specifically single point localisation, should be a primary tactile assessment employed to determine reasons for upper limb motor difficulties experienced by children with DCD.
Collapse
Affiliation(s)
- Lauren E Cox
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Elizabeth C Harris
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Megan L Auld
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Leanne M Johnston
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.
| |
Collapse
|
37
|
Dimwamwa E, Johnson MJ. Kinematic analysis of unilateral and bilateral drinking task after brain and periphery injuries. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:4558-61. [PMID: 26737308 PMCID: PMC10998636 DOI: 10.1109/embc.2015.7319408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this study, we aim to understand how functional movement is affected by various physical and neurological injuries. Using a novel system known as the Bilateral Assessment System (BiAS), we tracked the wrist movement of subjects with stroke, cerebral palsy, transradial amputations, as well as healthy individuals in space and in time as they completed a drinking task. The BiAS allowed us to analyze the kinematics of the movement of subjects to describe how specific impairment types at varying levels of the nervous system affect upper limb movement. Using kinematics to provide an objective analysis, the results suggest that bilateral ability is not analogous to unilateral ability and the importance of bilateral training, in addition to unilateral training, in the rehabilitation of injured persons is highlighted. In addition, motor, sensory, and strength impairment and subsequent ADL functional ability is a function of impairment level and not just impairment type.
Collapse
|
38
|
Fiori S, Guzzetta A, Pannek K, Ware RS, Rossi G, Klingels K, Feys H, Coulthard A, Cioni G, Rose S, Boyd RN. Validity of semi-quantitative scale for brain MRI in unilateral cerebral palsy due to periventricular white matter lesions: Relationship with hand sensorimotor function and structural connectivity. NEUROIMAGE-CLINICAL 2015; 8:104-9. [PMID: 26106533 PMCID: PMC4473818 DOI: 10.1016/j.nicl.2015.04.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 11/20/2022]
Abstract
AIM To provide first evidence of construct validity of a semi-quantitative scale for brain structural MRI (sqMRI scale) in children with unilateral cerebral palsy (UCP) secondary to periventricular white matter (PWM) lesions, by examining the relationship with hand sensorimotor function and whole brain structural connectivity. METHODS Cross-sectional study of 50 children with UCP due to PWM lesions using 3 T (MRI), diffusion MRI and assessment of hand sensorimotor function. We explored the relationship of lobar, hemispheric and global scores on the sqMRI scale, with fractional anisotropy (FA), as a measure of brain white matter microstructure, and with hand sensorimotor measures (Assisting Hand Assessment, AHA; Jebsen-Taylor Test for Hand Function, JTTHF; Melbourne Assessment of Unilateral Upper Limb Function, MUUL; stereognosis; 2-point discrimination). RESULTS Lobar and hemispheric scores on the sqMRI scale contralateral to the clinical side of hemiplegia correlated with sensorimotor paretic hand function measures and FA of a number of brain structural connections, including connections of brain areas involved in motor control (postcentral, precentral and paracentral gyri in the parietal lobe). More severe lesions correlated with lower sensorimotor performance, with the posterior limb of internal capsule score being the strongest contributor to impaired hand function. CONCLUSION The sqMRI scale demonstrates first evidence of construct validity against impaired motor and sensory function measures and brain structural connectivity in a cohort of children with UCP due to PWM lesions. More severe lesions correlated with poorer paretic hand sensorimotor function and impaired structural connectivity in the hemisphere contralateral to the clinical side of hemiplegia. The quantitative structural MRI scoring may be a useful clinical tool for studying brain structure-function relationships but requires further validation in other populations of CP.
Collapse
Key Words
- AHA, Assisting Hand Assessment
- Brain structure
- CP, cerebral palsy
- Diffusion
- FA, fractional anisotropy
- GMFCS, Gross Motor Function Classification System
- HARDI
- JTTHF, Jebsen–Taylor test of hand function
- MACS, Manual Ability Classification System
- MRI, magnetic resonance imaging
- MUUL, Melbourne Assessment of Unilateral Upper Limb function
- Magnetic resonance imaging
- PWM, periventricular white matter
- Sensorimotor function
- Unilateral cerebral palsy
- sqMRI, semi-quantitative MRI
Collapse
Affiliation(s)
- Simona Fiori
- IRCCS Fondazione Stella Maris, Pisa, Italy
- Corresponding author. Tel.: +39 050886313; fax: +39 050886324.
| | - Andrea Guzzetta
- IRCCS Fondazione Stella Maris, Pisa, Italy
- University of Pisa, Pisa, Italy
| | - Kerstin Pannek
- Australia E-Health Research Centre, Brisbane, Australia
- University of Queensland, School of Medicine, Brisbane, QLD, Australia
- Department of Computing, Imperial College London, Biomedical Image Analysis Group, London, UK
| | - Robert S. Ware
- School of Population Health, The University of Queensland, Brisbane, QLD, Australia
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Giuseppe Rossi
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Alan Coulthard
- Academic Discipline of Medical Imaging, Royal Brisbane and Women's Hospital, QLD, Australia
| | - Giovanni Cioni
- IRCCS Fondazione Stella Maris, Pisa, Italy
- University of Pisa, Pisa, Italy
| | - Stephen Rose
- Australia E-Health Research Centre, Brisbane, Australia
| | - Roslyn N. Boyd
- Queesland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Australia
| |
Collapse
|
39
|
Maitre NL, Key AP. Quantitative assessment of cortical auditory-tactile processing in children with disabilities. J Vis Exp 2014:e51054. [PMID: 24513961 DOI: 10.3791/51054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objective and easy measurement of sensory processing is extremely difficult in nonverbal or vulnerable pediatric patients. We developed a new methodology to quantitatively assess children's cortical processing of light touch, speech sounds and the multisensory processing of the 2 stimuli, without requiring active subject participation or causing children discomfort. To accomplish this we developed a dual channel, time and strength calibrated air puff stimulator that allows both tactile stimulation and sham control. We combined this with the use of event-related potential methodology to allow for high temporal resolution of signals from the primary and secondary somatosensory cortices as well as higher order processing. This methodology also allowed us to measure a multisensory response to auditory-tactile stimulation.
Collapse
Affiliation(s)
- Nathalie L Maitre
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University
| | | |
Collapse
|
40
|
Effect of body-scaled information on reaching in children with hemiplegic cerebral palsy: a pilot study. Pediatr Phys Ther 2014; 26:28-37. [PMID: 24356315 DOI: 10.1097/pep.0000000000000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study examined body-scaled information that specifies the reach patterns of children with hemiplegic cerebral palsy and children with typical development. METHODS Nine children with hemiplegic cerebral palsy (3-5 years) and 9 age-matched children with typical development participated in the study. They were required to reach and grasp 10 different pairs of cubes. Reach data were coded as either a 1-handed reach or a 2-handed reach. Dimensionless ratios were calculated by dividing the cube size by the maximal aperture between the index finger and thumb. A critical ratio was used to establish the shift from a 1-handed to an exclusive 2-handed reach. RESULTS The critical ratio was not significantly different for either preferred or nonpreferred arms within and between groups. All children used an exclusive 2-handed reach at a similar dimensionless ratio. CONCLUSION Our study provides evidence of the "fit" between environment (cube size) and the individual's capabilities (finger aperture) for reaching for both groups.
Collapse
|
41
|
Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia. Brain Struct Funct 2013; 220:307-18. [DOI: 10.1007/s00429-013-0656-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 10/09/2013] [Indexed: 10/26/2022]
|
42
|
Bleyenheuft Y, Gordon AM. Precision grip control, sensory impairments and their interactions in children with hemiplegic cerebral palsy: a systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3014-3028. [PMID: 23816634 DOI: 10.1016/j.ridd.2013.05.047] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 05/27/2013] [Accepted: 05/28/2013] [Indexed: 06/02/2023]
Abstract
Children with hemiplegic cerebral palsy (HCP) exhibit long-term functional deficits. One of the most debilitating is the loss of prehension since this may impair functional independence. This loss of prehension could be partly due to sensory deficits. Identifying the underlying causes of prehension deficits and their potential link with sensory disorders is important to better adapt neurorehabilitation. Here we provide an overview of precision grip and sensory impairments in individuals with HCP, and the relation between them, in order to determine whether the sensory impairments influence the type and magnitude of deficits as measured by studies of prehensile force control. Pubmed and Scopus databases were used to search studies from 1990 to 2012, using combinations of the following keywords: fingertip force; grip force; precision grip; sensory deficit; sensory impairment; tactile discrimination; with cerebral palsy. Of the 190 studies detected through the systematic search; 38 were finally included in the systematic part of this review. This review shows that sensory deficits are common and are likely underestimated using standard clinical assessments in HCP. Some studies suggest these deficits are the basis of predictive motor control impairments in these individuals. However, children with HCP retain some ability to use predictive control, even if it is impaired in the more affected hand. Intensive practice and initial use of the less affected hand, which has only subtle sensory deficits, has been shown to remediate impairments in anticipatory motor control during subsequent use of the more affected hand. Implications for motor and sensory rehabilitation of individuals with HCP are discussed.
Collapse
|