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Improvement of Praxis Skills in Children with Hemiplegic Cerebral Palsy by Using New Trend of Augmented Visual and Auditory Feedback Training: A Case Report  [PDF]
Safaa M. ElKholi, Reham S. Alsakhawi
Open Journal of Therapy and Rehabilitation (OJTR) , 2018, DOI: 10.4236/ojtr.2018.62004
Abstract: Aims: The aim of the study is to investigate if the new method of auditory and visual biofeedback as Upper Limb Exercise may improve praxis skills alone without any traditional physical therapy treatment or not and within three successive months of treatment in children with hemiplegic cerebral palsy. Methods: A 6-year-old hemiplegic cerebral palsied child was treated with Upper-Limb Exerciser as one of augmented visual and auditory feedback devices. Sensory Integration and Praxis test was used to measure a child’s ability to integrate sensory input for perception, motor planning, and spatial actions in; Space Visualization, Figure-Ground Perception, Standing and Walking Balance, Design Copying, Postural Praxis, Bilateral Motor Coordination, Constructional Praxis, Postrotary Nystagmus, Motor Accuracy, Sequencing Praxis, Oral Praxis, Manual Form Perception, Kinesthesia, Finger Identification, Graphethesia, Localization of Tactile Stimuli, and Praxis on Verbal Command. Results: The results revealed improvement of the major standard score for each of the 17 subtests of Sensory Integration and Praxis Test when compared after three successive treatment. Conclusion: The using upper limb exerciser as one method of augmented visual and auditory feedback can be used as one of the physical and occupational therapy programs aiming to improve praxis skills in hemiplegic cerebral palsied children.
Immediate Effect of Lateral-Wedged Insole on Postural Control in Children with Hemiplegic Cerebral Palsy
Sara Bayat,Saeed Talebian,Mahdi Abdolvahab,Shohre Jalaei
Modern Rehabilitation , 2011,
Abstract: Background and Aim: Cerebral palsy (CP) is the most common motor impairment in childhood and affects 2 in 1000 live births, in which postural and motor control involved. In hemiplegic type, two sides of the body have differences in postural tone that cause weight shift to the intact side. In these children postural disorders appear as postural stability disorder. The aim of this study is to assess the effect of lateral wedge insole on postural control in cerebral palsy children.Materials and Methods Sixteen hemiplegic children attended in this program and stood in two conditions on the force plate with and without lateral wedge on the hard plate. Center of pressure displacement measured for medio-lateral and antro-posterio directions. Every test took 20 seconds. It was repeated 3 times.Results: Range of sideways decreased significantly with use of 5o wedge. Also a shoe wedge of 5o provided symmetrical weight distribution.Conclusion: The results represent that a 5o lateral wedge applied to the unaffected limb, can improve factors of postural control and gain the symmetry in hemiplegic children
Comparison of EMG Biofeedback and Johnstone Pressure Splints in Children with Hemiplegic Cerebral Palsy  [cached]
Ali Kiti?,Hülya Kay?han
Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi , 2010,
Abstract: Objective: This study was carried out to compare Johnstone pressure splints and electromyographic (EMG) biofeedback in addition to neurodevelopmental therapy on activities of daily living, sensory perception and motor integration functions, functional hand activities, and muscle tone in children with hemiplegic cerebral palsy (CP). Materials and Methods: Thirty-eight children with spastic hemiplegic cerebral palsy, whose motor development levels were similar, were included in this study and were divided into two groups. In addition to Bobath’s neurodevelopmental therapy, Group I was treated with pressure splints for the upper extremity and Group II-with EMG biofeedback training, also applied to the upper extremity, three times a week for three months. In the biofeedback group the session length was 20 minutes and in the Johnstone group, it was 50 minutes in total, with and without splinting. Patients were evaluated for muscle tone, activities of daily living, sensory perception and motor integration functions, and functional hand activities before and after therapy, and on the third and sixth months following therapy. Results: At the third and sixth months after treatment, significant improvement was found in muscle tone, activities of daily living, sensory perception and motor integration functions, and functional hand activities (p<0.05). Moreover, the findings in Group I were more significant than those in Group II (p<0.001). Conclusion: These results show that both treatment methods are helpful to Bobath approach in cerebral palsy rehabilitation. However, EMG biofeedback treatment is more effective due to the fact that it encourages the child’s active participation. Turk J Phys Med Rehab 2010;56:116-23.
THE INFLUENCE OF THE EXERCISES OF GROSS AND FINE MOTOR SKILLS ON VISUO-MOTOR COORDINATION OF THE CEREBRAL PALSY CHILDREN
Almira Mujki?
Human : Research in Rehabilitation , 2013,
Abstract: Visuomotor coordination is reffered to eye coordination and to various parts of the body in different activities and games. The aim of the research was to establish the influence of the exercises of gross and fine motor skills on visuomotor coordination of the cerebral palsy children. The sample was the case study where a male person of 3 and a half years old was an examinee. Measuring instrument used was the Test of visuomotor coordination of the gross motor skills of the dominant hand. Data were analyzed by t-test.
Effect of Motor Imagery in Children with Unilateral Cerebral Palsy: fMRI Study  [PDF]
Eva Chinier, Sylvie N’Guyen, Grégoire Lignon, Aram Ter Minassian, Isabelle Richard, Micka?l Dinomais
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093378
Abstract: Background Motor imagery is considered as a promising therapeutic tool for rehabilitation of motor planning problems in patients with cerebral palsy. However motor planning problems may lead to poor motor imagery ability. Aim The aim of this functional magnetic resonance imaging study was to examine and compare brain activation following motor imagery tasks in patients with hemiplegic cerebral palsy with left or right early brain lesions. We tested also the influence of the side of imagined hand movement. Method Twenty patients with clinical hemiplegic cerebral palsy (sixteen males, mean age 12 years and 10 months, aged 6 years 10 months to 20 years 10 months) participated in this study. Using block design, brain activations following motor imagery of a simple opening-closing hand movement performed by either the paretic or nonparetic hand was examined. Results During motor imagery tasks, patients with early right brain damages activated bilateral fronto-parietal network that comprise most of the nodes of the network well described in healthy subjects. Inversely, in patients with left early brain lesion brain activation following motor imagery tasks was reduced, compared to patients with right brain lesions. We found also a weak influence of the side of imagined hand movement. Conclusion Decreased activations following motor imagery in patients with right unilateral cerebral palsy highlight the dominance of the left hemisphere during motor imagery tasks. This study gives neuronal substrate to propose motor imagery tasks in unilateral cerebral palsy rehabilitation at least for patients with right brain lesions.
Upper limb children action-observation training (UP-CAT): a randomised controlled trial in Hemiplegic Cerebral Palsy
Giuseppina Sgandurra, Adriano Ferrari, Giuseppe Cossu, Andrea Guzzetta, Laura Biagi, Michela Tosetti, Leonardo Fogassi, Giovanni Cioni
BMC Neurology , 2011, DOI: 10.1186/1471-2377-11-80
Abstract: The trial is designed according to CONSORT Statement. It is a randomised, evaluator-blinded, match-pair group trial. Children with HCP will be randomised within pairs to either experimental or control group. The experimental group will perform an Action-Observation Therapy, called UP-CAT (Upper Limb-Children Action-Observation Training) in which they will watch video sequences showing goal-directed actions, chosen according to children UL functional level, combined with motor training with their hemiplegic UL. The control group will perform the same tailored actions after watching computer games. A careful revision of psychometric properties of UL outcome measures for children with hemiplegia was performed. Assisting Hand Assessment was chosen as primary measure and, based on its calculation power, a sample size of 12 matched pairs was established. Moreover, Melbourne and ABILHAND-Kids were included as secondary measures. The time line of assessments will be T0 (in the week preceding the onset of the treatment), T1 and T2 (in the week after the end of the treatment and 8 weeks later, respectively). A further assessment will be performed at T3 (24 weeks after T1), to evaluate the retention of effects. In a subgroup of children enrolled in both groups functional Magnetic Resonance Imaging, exploring the mirror system and sensory-motor function, will be performed at T0, T1 and T2.The paper aims to describe the methodology of a RCT for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with hemiplegia. This study will be the first to test this new type of treatment in childhood. The paper presents the theoretical background, study hypotheses, outcome measures and trial methodology.NCT01016496Cerebral palsy (CP) is "a group of disorders of the development of movement and posture causing activity limitation that are attributed to non-progressive disturbance that occurred in the developing foetal or infant brain. The motor disorders
Having another look at cerebral palsy: Current definitions and classification systems  [cached]
Mary Rainey Perry
Voices: A World Forum for Music Therapy , 2011,
Abstract: Although many music therapists work with clients with cerebral palsy, this diagnostic term has a low profile in current music therapy literature. This is especially the case when the focus of intervention is not in the realm of physical functioning. The frequently co-occurring disorders in sensation, cognition, communication, perception, and behaviour are often the focus of music therapy intervention, particularly with children and adults with severe and multiple disability. Current perspectives on the care and participation of children and adults with cerebral palsy, including motor classification scales, can be useful for research and clinical reporting. These scales are explained and examined, as is the effect of the motor impairments of cerebral palsy on active music therapy methods. Clinical vignettes illustrate the effect of different levels of functional fine motor skills as assessed by the Manual Ability Classification System (Eliasson, A.C., et al, 2006) on musical interaction. Including the term “cerebral palsy” in clinical reports and research also has implications for awareness of music therapy in the wider community.
Effect of Motor-Rehabilitation Training Programme for Children with Cerebral Palsy
Ayed H. Ziadat
Journal of Medical Sciences , 2007,
Abstract: The objective of this study was to determine the impact of implementing a sport-training programme to improve motor-rehabilitation skills in children with cerebral palsy. Such improvements became evident on the gross and fine muscular motions due to the implemented motor-rehabilitation-training programme. The sport-training programmeme used a variety of motional tests on children 8-12 years of age diagnosed with cerebral palsy. Four males and four females with mild spasticity participated in the programme. The sport-training programme aimed to improve coordination, accuracy, flexibility, neuro-muscular coordination, ability to balance and also the visual/optic-motor coordination including motor awareness among the chosen group of children. Motor experiments were conducted, improvements due to the programme reached acceptable and adequate results as true indicators. Statistical analyses such as the t-test and Wilcoxon test for two-related samples before t and after were applied on the results of the training sport-programme. The results showed some differences in the average of pre and aft-measurements in the general motor skills experiments. Differences were also found in the average of pre and aft-measurement in the fine motor skills for the aft-measurements. The difference was within (α<=0.05).
HARDSHIPS OF CEREBRAL PALSY PUPILS IN ACQUIRING ART CLASSES TASKS AND EXCPETED ACCOMPLISHMENTS  [PDF]
Radmila CHUKIKJ,Fadilj EMINOVIKJ,Meho SHUTKOVIKJ
Journal of Special Education and Rehabilitation , 2008,
Abstract: Program contents for cerebral palsy pupils in the elementary school are a modification of the pro-gram contents for pupils with mental retardation. However, those program contents are not adjusted with cognitive and movement abilities of cerebral palsy pupils, thus, they have difficulties in learning those program contents. This especially refers to subjects for acquiring skills. This research refers to the adjustment of cognitive and movement abilities of students, program contents for the subject arts culture and the expected resultsThe level of the obtained results was 19%-70%. On the basis of applied tests, the status for each pupil was determined. The relation between the results of the shown abilities for learning the pro-gram contents of fine arts and the objectively shown abilities for the applied tests have to be the basis for creating program contents adjusted for psycho-motor abilities for each pupil, and the working results can adequately be evaluated, i.e. the students can be assessed.
Estudo da independência funcional, motricidade e inser o escolar de crian as com Paralisia Cerebral Study of functional independence, motor skills and school integration of children with Cerebral Palsy  [cached]
Geovana S?ffa Rézio,Jackeline Oliveira do Vale Cunha,Cibelle Kayenne Martins Roberto Formiga
Revista Brasileira de Educa??o Especial , 2012, DOI: 10.1590/s1413-65382012000400005
Abstract: A Paralisia Cerebral (PC) é uma condi o clínica que gera alta prevalência de sequelas funcionais. As crian as com este diagnóstico podem apresentar diversos problemas nas atividades funcionais e no controle dos movimentos voluntários. O objetivo deste trabalho foi analisar o nível de independência funcional, motricidade e inser o escolar de crian as com PC. A amostra foi composta por 14 crian as com idade entre um a 11 anos que frequentam regularmente o Setor Clínico da Associa o Pestalozzi de Goiania, seus respectivos pais e/ou responsáveis e professores do ensino escolar. Os resultados mostraram que quanto maior o nível de independência funcional e melhor o desempenho na fun o motora grossa das crian as com Paralisia Cerebral, menor é a assistência fornecida pelos cuidadores e menos adapta es s o necessárias para que essas crian as realizem as tarefas do ensino escolar. é importante uma parceria entre os profissionais da saúde com os professores, através de orienta es e contribui es, no que for necessário para a inclus o escolar das crian as com deficiência. Cerebral Palsy is a medical condition that causes high prevalence of functional sequelae. For this reason, children with this diagnosis can present several problems in functional activities related to controlling voluntary movements. The aim of this study was to examine the level of functional independence, motor skills and school integration of children with cerebral palsy. The sample consisted of 14 children aged one to 11 years attending regularly the Clinical Sector of the Pestalozzi Association Goiania Unit, their parents and/or guardians and school teachers. The results showed that the higher the level of functional independence and the better their performance in gross motor function of these children with cerebral palsy, the lower the assistance provided by caregivers and fewer the adjustments needed for these children to perform tasks required of them in school. The study showed the importance of health professionals and teachers working together whenever needed, through orientation and contributions, for the educational inclusion of children with disabilities.
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