The Hand Functions In Cerebral Palsy

Bursa Uludag University

Status: Completed

Conditions: Hand Functions; Cerebral Palsy

Treatments: Other: TT+CIMT; Other: TT; Other: TT+CIMT+VR

Study type: Interventional

Funder types: Other

Identifiers

NCT05988944

CIMT vs VR

Details and patient eligibility

About

The hand motor functions are very important in the daily life activities, educational, and social participation of children. Losing The hand motor functions limit these activities and participation. Constraint-induced movement therapy (CIMT) or virtual reality (VR) therapy has often been preferred to improve the hand's motor functions.

Full description

CIMT and VR are used to improve the motor functions of the hand in cerebral palsy (CP). The aim of this study was to compare the effects of CIMT-VR use and only CIMT use on hand functions in children with hemiparetic cerebral palsy. Hand function and performance were evaluated with the Jebsen-Taylor and Moberg pick-up tests. All evaluations were made twice; before the first therapy and after six weeks. Children with hemiparetic CP were divided into three groups randomly (Traditional techniques (TT), TT+CIMT, and TT+CIMT+VR).

Enrollment: 45 patients

Sex: All

Ages: 8 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

The inclusion criteria of the study were determined to be

• aged 8 to 18 years,
• diagnosed with hemiparetic CP,
• being level 2 or 3 according to the gross motor function measurement scale and the manual ability classification system.

The exclusion criteria of the study were,

• severe cognitive dysfunction that rendered them unable to perform simple tasks (e.g., reaching, grasping),
• having pharmacologic medicine for spasticity,
• having botulinum toxin A injections in the last 6 months,
• having upper extremity surgery,
• having visual and/or auditory problems which affect therapy or evaluation.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

45 participants in 3 patient groups

Traditional techniques

Active Comparator group

Description:

TT was planned according to the child's hand that was needed. Neurodevelopmental facilitation techniques (Bobath therapy), stretching, and grasping types (cylindrical, spherical, hook, key, fingertip, lateral) were used in hands therapy for 45 minutes two days in a week for all children who were accepted to participate in this study.

Treatment:

Other: TT

traditional therapy with constraint induced movement therapy

Experimental group

Description:

The sling was put on the child's non-paretic arm to apply CIMT. The around of the sling was sewn except the elbow and secured snugly to the trunk with a waist strap to prevent assisting the affected hand during the application of CIMT. However, children with CP who were in the this group used the sling for three hours in daily activity, playing, etc. at home. The CIMT was given as a home program and monitorization was done by the follow-up form every week with no therapy during the weekend.

Treatment:

Other: TT+CIMT

traditional therapy with constraint induced movement therapy and virtual reality

Experimental group

Description:

After the TT session, a child with CP used the sling for 45 minutes at the rehabilitation center with VR therapy. VR therapy with CIMT was used in hands therapy for 45 minutes at two days a week after TT. During the VR therapy, the child was encouraged verbally to play X-box.The X-box Kinect 360 (by the Microsoft corporation) was used for VR therapy. It has a kinetic sensor that perceives the movement of the child with CP. The child's movement can be seen through the monitor in real time. VR does not need special buttons to play. Therefore, a child with CP who had impaired fine motor skills and dexterity can play easily.

Treatment:

Other: TT+CIMT+VR