Research Article
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Upper limb training using visual feedback for children with cerebral palsy

Year 2022, Volume: 9 Issue: 3, 179 - 188, 19.12.2022
https://doi.org/10.15437/jetr.878969

Abstract

Purpose: This study aimed to investigate that if upper limb visual feedback training added to the usual therapy was effective on upper limb functions in children with cerebral palsy. Methods: Thirty-eight children with cerebral palsy (4-18 years) participated in the study. The participants were randomly assigned into two groups. Study group (n=19, mean age 8.50±3.40, 53% female) received visual feedback training plus usual therapy twice a week for 8 weeks, 16 sessions in total, while control group (n=19, mean age 10.60±3.80, 42% female) received only usual therapy. The participants’ Gross Motor Function Classification System levels were between I-III and spasticity levels were between ‘0’ to ‘1+’ according to Modified Ashworth Scale. Upper limb range of motion (ROM), grip and pinch strength, hand skills (Minnesota Manual Dexterity Test (MMDT)), and functional abilities (Childhood Health Assessment Questionnaire (CHAQ)) were assessed before and after treatment. Results: The change amount in shoulder flexion (p=0.004) and abduction (p=0.01), supination (p=0.019) and wrist flexion (p=0.004) and extension (p=0.00) ROM values; bilateral MMDT scores (p=0.003) were statistically significantly improved in study group compared to control group. Conclusion: Adding visual feedback training to the usual therapy program of children with cerebral palsy was found to be effective in some outcome measurements such as upper limb ROM and hand skills. In the long-term rehabilitation process, this new training method may be an alternative additive option for children, families, and physiotherapists.

Supporting Institution

Scientific Research Project Committee of Marmara University

Project Number

SAG-C-YLP-150218-0046

Thanks

These funds were used primarily for the purchasing of the equipment. This fund provider had no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript.

References

  • 1. Swaiman KF, Ashwal S, Ferriero DM, et al. Swaiman's Pediatric Neurology E-Book: Principles and Practice: Elsevier Health Sciences; 2017.
  • 2. Maenner MJ, Blumberg SJ, Kogan MD, et al. Prevalence of cerebral palsy and intellectual disability among children identified in two US National Surveys, 2011–2013. Ann Epidemiol. 2016;26:222-226.
  • 3. Kruse M, Michelsen SI, Flachs EM, et al. Lifetime costs of cerebral palsy. Dev Med Child Neurol. 2009 Aug;51:622-628.
  • 4. Avery LM, Russell DJ, Raina PS, et al. Rasch analysis of the Gross Motor Function Measure: validating the assumptions of the Rasch model to create an interval-level measure. Arch Phys Med Rehabil. 2003;84:697-705.
  • 5. Wallen M, Stewart K. Upper limb function in everyday life of children with cerebral palsy: description and review of parent report measures. Disabil Rehabil. 2015;37:1353-1361.
  • 6. Porfírio GJ, Riera R, Martimbianco ALC, et al. Neurodevelopmental treatment approaches for children with cerebral palsy. Cochrane Database Syst Rev. 2018;2018(8):CD011937.
  • 7. Ito S, Gomi H. Visually-updated hand state estimates modulate the proprioceptive reflex independently of motor task requirements. Elife. 2020;9:e52380.
  • 8. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture. 2002;16:1-14.
  • 9. Snider L, Majnemer A, Darsaklis V. Virtual reality as a therapeutic modality for children with cerebral palsy. Dev Neurorehabil. 2010;13:120-128.
  • 10. Chiu H-C, Ada L, Lee H-M. Upper limb training using Wii Sports Resort™ for children with hemiplegic cerebral palsy: a randomized, single-blind trial. Clin Rehabil. 2014;28:1015-1024.
  • 11. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67:206-207.
  • 12. Rosenbaum PL, Palisano RJ, Bartlett DJ, et al. Development of the Gross Motor Function Classification System for cerebral palsy. Dev Med Child Neurol. 2008;50:249-253.
  • 13. Reese NB, Bandy WD. Joint range of motion and muscle length testing-E-book: Elsevier Health Sciences; 2016.
  • 14. Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review. BMC Geriatr. 2017;17:238-238.
  • 15. Tredgett MW, Davis TR. Rapid repeat testing of grip strength for detection of faked hand weakness. J Hand Surg Br. 2000;25:372-375.
  • 16. Tesio L, Simone A, Zebellin G, et al. Bimanual dexterity assessment: validation of a revised form of the turning subtest from the Minnesota Dexterity Test. Int J Rehabil Res. 2016;39:57-62.
  • 17. Ruperto N, Ravelli A, Pistorio A, et al. Cross-cultural adaptation and psychometric evaluation of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ) in 32 countries. Review of the general methodology. Clin Exp Rheumatol. 2001;19:S1-S9.
  • 18. Zoccolillo L, Morelli D, Cincotti F, et al. Video-game based therapy performed by children with cerebral palsy: a cross-over randomized controlled trial and a cross-sectional quantitative measure of physical activity. Eur J Phys Rehabil Med. 2015;51:669-676.
  • 19. Gilliaux M, Renders A, Dispa D, et al. Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial. Neurorehabil Neural Repair. 2015;29:183-192.
  • 20. Park E-Y, Kim E-J. Effect of the frequency of therapy on the performance of activities of daily living in children with cerebral palsy. J Phys Ther Sci. 2018;30707-30710.
  • 21. Kandel ER, Schwartz JH, Jessell TM, et al. Principles of neural science. Vol 4: McGraw-Hill New York; 2000.
  • 22. Plautz EJ, Milliken GW, Nudo RJ. Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiol Learn Mem. 2000;74:27-55.
  • 23. Butler C, Darrah J. Effects of neurodevelopmental treatment (NDT) for cerebral palsy: an AACPDM evidence report. Dev Med Child Neurol. 2001;43:778-790.
  • 24. Tarakci D, Ersoz Huseyinsinoglu B, et al. Effects of Nintendo Wii-Fit® video games on balance in children with mild cerebral palsy. Pediatr Int. 2016;58:1042-1050.
  • 25. Mackey AH, Walt SE, Stott NS. Deficits in upper-limb task performance in children with hemiplegic cerebral palsy as defined by 3-dimensional kinematics. Arch Phys Med Rehabil. 2006;87:207-215.
  • 26. Eliasson AC, Krumlinde-Sundholm L, Gordon AM, et al. Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Dev Med Child Neurol. 2014;56:125-137.
  • 27. Hutzler Y, Rodríguez BL, Laiz NM, et al. The effects of an exercise training program on hand and wrist strength, and function, and activities of daily living, in adults with severe cerebral palsy. Res Dev Disabil. 2013;34:4343-4354.
  • 28. Morales NMO, Funayama CAR, Rangel VO, et al. Psychometric properties of the Child Health Assessment Questionnaire (CHAQ) applied to children and adolescents with cerebral palsy. Health Qual Life Outcomes. 2008;6:109.
  • 29. Büğüşan S, Kahraman A, Elbasan B, et al. Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life? Disab Health J. 2018;11:287-292.
  • 30. Alamer A, Melese H, Adugna B. Effectiveness of action observation training on upper limb motor function in children with hemiplegic cerebral palsy: a systematic review of randomized controlled trials. Pediatric Health Med Ther. 2020;11:335-346.
  • 31. Burdea GC. Virtual rehabilitation--benefits and challenges. Methods Inf Med. 2003;42:519-523.

Serebral palsili çocuklarda görsel geri bildirim kullanımı ile üst ekstremite eğitimi

Year 2022, Volume: 9 Issue: 3, 179 - 188, 19.12.2022
https://doi.org/10.15437/jetr.878969

Abstract

Amaç: Bu çalışmanın amacı, serebral palsi tanısı olan çocuklarda rutin tedaviye eklenen üst ekstremite görsel geribildirim eğitiminin üst ekstremite fonksiyonları üzerine etkisini araştırmaktı. Yöntem: Çalışmaya serebral palsi tanılı (4-18 yaş) 38 çocuk katıldı. Katılımcılar randomize olarak iki gruba ayrıldı. Çalışma grubu (n=19, ortalama yaş 8,50±3,40, %53 kadın) 8 hafta boyunca haftada 2 kez görsel geribildirim eğitimi ve rutin tedavi alırken, kontrol grubu (n=19, ortalama yaş 10,60±3,80, %42 kadın) sadece rutin tedavi aldı. Kaba Motor Fonksiyonel Sınıflandırma Sistemi seviyeleri I-III arasında ve spastisite seviyeleri Modifiye Ashworth Ölçeği’ne göre "0" ile "1+" arasında olan çocuklar çalışmaya dahil edildi. Üst ekstremite hareket açıklığı (EHA), kavrama ve çimdik gücü, el becerileri (Minnesota Manual Dexterity Test (MMDT)) ve fonksiyonel yetenekler (Childhood Health Assessment Questionnaire (CHAQ)) tedavi öncesi ve sonrasında değerlendirildi. Bulgular: Çalışma grubunda omuz fleksiyonu (p=0,004) ve abdüksiyon (p=0,01), supinasyon (p=0,019) ve bilek fleksiyonu (p=0,004) ve ekstansiyon (p=0,00) EHA değerleri; bilateral MMDT puanları (p=0,003) kontrol grubuna göre istatistiksel olarak anlamlı şekilde gelişti. Sonuç: Görsel geribildirim eğitimini serebral palsi tanısı ile rehabilitasyon uygulanan çocukların tedavi programına eklemenin üst ekstremite EHA ve el becerileri gibi bazı sonuç ölçümlerinde etkili olduğu bulundu. Uzun süreli rehabilitasyon sürecinde bu yeni yöntem çocuklar, aileler ve fizyoterapistler için tedaviye eklenebilecek alternatif bir seçenek olabilir.

Project Number

SAG-C-YLP-150218-0046

References

  • 1. Swaiman KF, Ashwal S, Ferriero DM, et al. Swaiman's Pediatric Neurology E-Book: Principles and Practice: Elsevier Health Sciences; 2017.
  • 2. Maenner MJ, Blumberg SJ, Kogan MD, et al. Prevalence of cerebral palsy and intellectual disability among children identified in two US National Surveys, 2011–2013. Ann Epidemiol. 2016;26:222-226.
  • 3. Kruse M, Michelsen SI, Flachs EM, et al. Lifetime costs of cerebral palsy. Dev Med Child Neurol. 2009 Aug;51:622-628.
  • 4. Avery LM, Russell DJ, Raina PS, et al. Rasch analysis of the Gross Motor Function Measure: validating the assumptions of the Rasch model to create an interval-level measure. Arch Phys Med Rehabil. 2003;84:697-705.
  • 5. Wallen M, Stewart K. Upper limb function in everyday life of children with cerebral palsy: description and review of parent report measures. Disabil Rehabil. 2015;37:1353-1361.
  • 6. Porfírio GJ, Riera R, Martimbianco ALC, et al. Neurodevelopmental treatment approaches for children with cerebral palsy. Cochrane Database Syst Rev. 2018;2018(8):CD011937.
  • 7. Ito S, Gomi H. Visually-updated hand state estimates modulate the proprioceptive reflex independently of motor task requirements. Elife. 2020;9:e52380.
  • 8. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture. 2002;16:1-14.
  • 9. Snider L, Majnemer A, Darsaklis V. Virtual reality as a therapeutic modality for children with cerebral palsy. Dev Neurorehabil. 2010;13:120-128.
  • 10. Chiu H-C, Ada L, Lee H-M. Upper limb training using Wii Sports Resort™ for children with hemiplegic cerebral palsy: a randomized, single-blind trial. Clin Rehabil. 2014;28:1015-1024.
  • 11. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67:206-207.
  • 12. Rosenbaum PL, Palisano RJ, Bartlett DJ, et al. Development of the Gross Motor Function Classification System for cerebral palsy. Dev Med Child Neurol. 2008;50:249-253.
  • 13. Reese NB, Bandy WD. Joint range of motion and muscle length testing-E-book: Elsevier Health Sciences; 2016.
  • 14. Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review. BMC Geriatr. 2017;17:238-238.
  • 15. Tredgett MW, Davis TR. Rapid repeat testing of grip strength for detection of faked hand weakness. J Hand Surg Br. 2000;25:372-375.
  • 16. Tesio L, Simone A, Zebellin G, et al. Bimanual dexterity assessment: validation of a revised form of the turning subtest from the Minnesota Dexterity Test. Int J Rehabil Res. 2016;39:57-62.
  • 17. Ruperto N, Ravelli A, Pistorio A, et al. Cross-cultural adaptation and psychometric evaluation of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ) in 32 countries. Review of the general methodology. Clin Exp Rheumatol. 2001;19:S1-S9.
  • 18. Zoccolillo L, Morelli D, Cincotti F, et al. Video-game based therapy performed by children with cerebral palsy: a cross-over randomized controlled trial and a cross-sectional quantitative measure of physical activity. Eur J Phys Rehabil Med. 2015;51:669-676.
  • 19. Gilliaux M, Renders A, Dispa D, et al. Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial. Neurorehabil Neural Repair. 2015;29:183-192.
  • 20. Park E-Y, Kim E-J. Effect of the frequency of therapy on the performance of activities of daily living in children with cerebral palsy. J Phys Ther Sci. 2018;30707-30710.
  • 21. Kandel ER, Schwartz JH, Jessell TM, et al. Principles of neural science. Vol 4: McGraw-Hill New York; 2000.
  • 22. Plautz EJ, Milliken GW, Nudo RJ. Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiol Learn Mem. 2000;74:27-55.
  • 23. Butler C, Darrah J. Effects of neurodevelopmental treatment (NDT) for cerebral palsy: an AACPDM evidence report. Dev Med Child Neurol. 2001;43:778-790.
  • 24. Tarakci D, Ersoz Huseyinsinoglu B, et al. Effects of Nintendo Wii-Fit® video games on balance in children with mild cerebral palsy. Pediatr Int. 2016;58:1042-1050.
  • 25. Mackey AH, Walt SE, Stott NS. Deficits in upper-limb task performance in children with hemiplegic cerebral palsy as defined by 3-dimensional kinematics. Arch Phys Med Rehabil. 2006;87:207-215.
  • 26. Eliasson AC, Krumlinde-Sundholm L, Gordon AM, et al. Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Dev Med Child Neurol. 2014;56:125-137.
  • 27. Hutzler Y, Rodríguez BL, Laiz NM, et al. The effects of an exercise training program on hand and wrist strength, and function, and activities of daily living, in adults with severe cerebral palsy. Res Dev Disabil. 2013;34:4343-4354.
  • 28. Morales NMO, Funayama CAR, Rangel VO, et al. Psychometric properties of the Child Health Assessment Questionnaire (CHAQ) applied to children and adolescents with cerebral palsy. Health Qual Life Outcomes. 2008;6:109.
  • 29. Büğüşan S, Kahraman A, Elbasan B, et al. Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life? Disab Health J. 2018;11:287-292.
  • 30. Alamer A, Melese H, Adugna B. Effectiveness of action observation training on upper limb motor function in children with hemiplegic cerebral palsy: a systematic review of randomized controlled trials. Pediatric Health Med Ther. 2020;11:335-346.
  • 31. Burdea GC. Virtual rehabilitation--benefits and challenges. Methods Inf Med. 2003;42:519-523.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Dilara Merve Sarı 0000-0001-7443-3747

Tuğba Kuru 0000-0002-3263-2278

Project Number SAG-C-YLP-150218-0046
Publication Date December 19, 2022
Submission Date February 12, 2021
Published in Issue Year 2022 Volume: 9 Issue: 3

Cite

Vancouver Sarı DM, Kuru T. Upper limb training using visual feedback for children with cerebral palsy. JETR. 2022;9(3):179-88.