A multi-site study of functional outcomes following a themed approach to hand-arm bimanual intensive therapy for children with hemiplegia

• Aim:This study investigated the effects of a theme-based ('magic') variation of the hand-arm bimanual intensive therapy programme, in two different countries, in improving activity performance for children with hemiplegia, including those with severe movement restrictions.Method:Twenty-three children with spastic hemiplegia (13 males, 10 females; mean age 10y 7mo, range 7-15y; Manual Ability Classification System level I, two; level II, 13; level III, eight), participated in one of three, 2-week, summer camps. A within-participant experimental design was used with the Assisting Hand Assessment and Children's Hand Experience Questionnaire as primary outcome measures. Evaluations occurred immediately before the first day, on the last day, and 3 months after intervention. Two groups underwent additional assessments 2 weeks before the camp.Results:Significant intervention effects were seen on the Assisting Hand Assessment (p=0.002) and on the Children's Hand Experience Questionnaire (p<0.001), the latter maintained at follow-up. The affected hand was reported to be used in 25% of bimanual activities before the camp, progressing to 93% after camp, and decreasing to 86% at follow-up. Severity of impairment did not influence progress.Interpretation:This themed approach to intensive intervention showed positive results in bimanual use, with improvements in independence sustained at follow-up. Although children across camps and motor severity made progress, some questions remain about intensity and duration of intervention to optimize longer-term outcomes.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

adolescent

article

Assisting Hand Assessment

behavior disorder

child

childhood disease

Children Hand Experience Questionnaire

clinical article

comparative study

controlled study

evaluation

experimental design

female

follow up

functional assessment

group dynamics

hand arm bimanual intensive therapy

hand movement

hemiplegia

human

independence

Israel

learning disorder

male

movement therapy

named inventories

questionnaires and rating scales

outcome assessment

performance

priority journal

school child

skill

United Kingdom

Age Factors

Arm

Exercise Therapy

Follow-Up Studies

Functional Laterality

Great Britain

Hand

Humans

Motivation

Motor Skills

Questionnaires

Severity of Illness Index

Treatment Outcome

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)