Emma Kirkpatrick1, Janice Pearse2, Peter James3, Anna Basu4. 1. Southampton Clinical Trials Unit, University of Southampton, Southampton, UK. 2. Paediatric Occupational Therapy Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. 3. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. 4. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Abstract
AIM: To determine whether home-based, parent-delivered therapy comprising action observation (AO) and repeated practice (RP) improves upper limb function more than RP alone in children with unilateral cerebral palsy (UCP). DESIGN: single-blinded parallel-group randomized controlled trial with 1:1 allocation comparing AO+RP (intervention) with RP alone (control). RANDOMIZATION: computer-generated, with allocation concealment by opaque sequentially-numbered envelopes. SETTING: northern England, August 2011 to September 2013. PARTICIPANTS: 70 children with UCP; mean age 5.6 years (SD 2.1), 31 female. INTERVENTION: home-based activities were provided, tailored to interests and abilities. DURATION: 15 minutes/day, 5 days/week for 3 months. ASSESSMENTS: Assisting Hand Assessment (AHA; primary outcome measure), Melbourne Assessment 2 (MA2), and ABILHAND-Kids at baseline, 3 months, and 6 months. RESULTS: Outcome data was available at 3 months for 28 children in the AO+RP group and 31 controls, and at 6 months for 26 and 28 children respectively. There were no between-group differences in AHA, MA2, or ABILHAND-Kids at 3 or 6 months versus baseline (all p>0.05). Combined-group improvements (p<0.001), observed in AHA and MA2 at 3 months, were maintained at 6 months. ABILHAND-Kids also showed improvement at 3 months (p=0.003), maintained at 6 months. INTERPRETATION: Parent-delivered RP (with or without AO) improves upper limb function and could supplement therapist input.
AIM: To determine whether home-based, parent-delivered therapy comprising action observation (AO) and repeated practice (RP) improves upper limb function more than RP alone in children with unilateral cerebral palsy (UCP). DESIGN: single-blinded parallel-group randomized controlled trial with 1:1 allocation comparing AO+RP (intervention) with RP alone (control). RANDOMIZATION: computer-generated, with allocation concealment by opaque sequentially-numbered envelopes. SETTING: northern England, August 2011 to September 2013. PARTICIPANTS: 70 children with UCP; mean age 5.6 years (SD 2.1), 31 female. INTERVENTION: home-based activities were provided, tailored to interests and abilities. DURATION: 15 minutes/day, 5 days/week for 3 months. ASSESSMENTS: Assisting Hand Assessment (AHA; primary outcome measure), Melbourne Assessment 2 (MA2), and ABILHAND-Kids at baseline, 3 months, and 6 months. RESULTS: Outcome data was available at 3 months for 28 children in the AO+RP group and 31 controls, and at 6 months for 26 and 28 children respectively. There were no between-group differences in AHA, MA2, or ABILHAND-Kids at 3 or 6 months versus baseline (all p>0.05). Combined-group improvements (p<0.001), observed in AHA and MA2 at 3 months, were maintained at 6 months. ABILHAND-Kids also showed improvement at 3 months (p=0.003), maintained at 6 months. INTERPRETATION: Parent-delivered RP (with or without AO) improves upper limb function and could supplement therapist input.
Authors: Laura W M E Beckers; Mellanie M E Geijen; Jos Kleijnen; Eugene A A Rameckers; Marlous L A P Schnackers; Rob J E M Smeets; Yvonne J M Janssen-Potten Journal: BMJ Open Date: 2020-10-06 Impact factor: 2.692
Authors: Brian J Hoare; Margaret A Wallen; Megan N Thorley; Michelle L Jackman; Leeanne M Carey; Christine Imms Journal: Cochrane Database Syst Rev Date: 2019-04-01
Authors: Anna Purna Basu; Janice Elizabeth Pearse; Jessica Baggaley; Rose Mary Watson; Tim Rapley Journal: BMC Pediatr Date: 2017-01-23 Impact factor: 2.125