Marina B Brandão1, Claudio Ferre2, Hsing-Ching Kuo2, Eugene A A Rameckers3, Yannick Bleyenheuft4, Ya-Ching Hung5, Kathleen Friel6, Andrew M Gordon7. 1. Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil. 2. Teachers College, Columbia University, New York, NY, USA. 3. Maastricht University, Maastricht, Netherlands University for Professionals for Pediatric Physical Therapy, AVANSplus, Breda, Netherlands. 4. Université Catholique de Louvain, Brussels, Belgium. 5. Queens College, City University of New York, Flushing, NY, USA. 6. Burke-Cornell Medical Research Institute, White Plains, NY, USA. 7. Teachers College, Columbia University, New York, NY, USA ag275@columbia.edu.
Abstract
UNLABELLED: Background High-intensity training aims to improve hand function in children with unilateral spastic cerebral palsy (USCP). However, the extent to which skill training is required is not known. Objectives To compare the effects of intensive bimanual training with and without structured progression of skill difficulty, on manual dexterity, bimanual hand use, daily functioning, and functional goals in children with USCP. Method Twenty-two children were randomized to structured practice group (SPG) or unstructured practice group (UPG), and received 6 h/d training during 15 days. Children from the SPG were engaged in fine and gross motor bimanual activities, with skill progression and goal training. Children from UPG performed the same activities without skill progression or goal training. Participants were evaluated before, immediately and 6 months after training by a physical therapist blinded to group allocation. The primary outcomes were the Jebsen-Taylor Test of Hand Function (JTTHF) and Assisting Hand Assessment (AHA). Secondary outcomes included the Canadian Occupational Performance Measure (COPM), Pediatric Evaluation of Disability Inventory (PEDI), and ABILHAND-Kids. Results Both groups showed similar improvements in the JTTHF, AHA, ABILHAND-Kids, COPM-satisfaction, and PEDI (P < .05). A significant interaction in the COPM-performance scale (P = .03) showed superior improvements of the SPG immediately, but not 6 months, after the intervention. CONCLUSIONS: Children from both groups demonstrated improvements in dexterity and functional hand use. This suggests that for intensive bimanual approaches, intensive training at such high doses may not require structured practice to elicit improvements. However, there may be immediate added benefit of including goal training.
RCT Entities:
UNLABELLED: Background High-intensity training aims to improve hand function in children with unilateral spastic cerebral palsy (USCP). However, the extent to which skill training is required is not known. Objectives To compare the effects of intensive bimanual training with and without structured progression of skill difficulty, on manual dexterity, bimanual hand use, daily functioning, and functional goals in children with USCP. Method Twenty-two children were randomized to structured practice group (SPG) or unstructured practice group (UPG), and received 6 h/d training during 15 days. Children from the SPG were engaged in fine and gross motor bimanual activities, with skill progression and goal training. Children from UPG performed the same activities without skill progression or goal training. Participants were evaluated before, immediately and 6 months after training by a physical therapist blinded to group allocation. The primary outcomes were the Jebsen-Taylor Test of Hand Function (JTTHF) and Assisting Hand Assessment (AHA). Secondary outcomes included the Canadian Occupational Performance Measure (COPM), Pediatric Evaluation of Disability Inventory (PEDI), and ABILHAND-Kids. Results Both groups showed similar improvements in the JTTHF, AHA, ABILHAND-Kids, COPM-satisfaction, and PEDI (P < .05). A significant interaction in the COPM-performance scale (P = .03) showed superior improvements of the SPG immediately, but not 6 months, after the intervention. CONCLUSIONS:Children from both groups demonstrated improvements in dexterity and functional hand use. This suggests that for intensive bimanual approaches, intensive training at such high doses may not require structured practice to elicit improvements. However, there may be immediate added benefit of including goal training.
Authors: Ana R P Smorenburg; Andrew M Gordon; Hsing-Ching Kuo; Claudio L Ferre; Marina Brandao; Yannick Bleyenheuft; Jason B Carmel; Kathleen M Friel Journal: Neurorehabil Neural Repair Date: 2016-11-17 Impact factor: 3.919
Authors: Hsing-Ching Kuo; Andrew M Gordon; Aline Henrionnet; Sylvie Hautfenne; Kathleen M Friel; Yannick Bleyenheuft Journal: Res Dev Disabil Date: 2015-12-14
Authors: Kathleen M Friel; Hsing-Ching Kuo; Jason Fuller; Claudio L Ferre; Marina Brandão; Jason B Carmel; Yannick Bleyenheuft; Jaimie L Gowatsky; Arielle D Stanford; Stefan B Rowny; Bruce Luber; Bruce Bassi; David L K Murphy; Sarah H Lisanby; Andrew M Gordon Journal: Neurorehabil Neural Repair Date: 2016-02-11 Impact factor: 3.919
Authors: Kathleen M Friel; Preston T J A Williams; Najet Serradj; Samit Chakrabarty; John H Martin Journal: Front Neurol Date: 2014-11-24 Impact factor: 4.003
Authors: Andrew M Gordon; Claudio L Ferre; Maxime T Robert; Karen Chin; Marina Brandao; Kathleen M Friel Journal: BMJ Open Date: 2022-02-21 Impact factor: 2.692
Authors: Hsing-Ching Kuo; Claudio L Ferre; Jason B Carmel; Jaimie L Gowatsky; Arielle D Stanford; Stefan B Rowny; Sarah H Lisanby; Andrew M Gordon; Kathleen M Friel Journal: Dev Med Child Neurol Date: 2016-07-27 Impact factor: 5.449