Home based computer-assisted upper limb exercise for young children with cerebral palsy: A feasibility study investigating impact on motor control and functional outcome
Andrew Weightman, Nick Preston, Martin Levesley, Raymond Holt, Mark Mon-Williams, Mike Clarke, Alastair J. Cozens, Bipin Bhakta
Objective: We developed a home-based rehabilitation exercise system incorporating a powered joystick linked to a computer game, to enable children with arm paresis to participate in independent home exercise. We investigated the feasibility and impact of using the system in the home setting.
Methods: Eighteen children with cerebral palsy (median age 7.5 years, age range 5–16 years) were recruited from local National Health Service and the exercise system was installed in their home for approximately 4 weeks. Baseline and post-intervention assessments were taken: Canadian Occupational Performance Measure (COPM); kinematic measurement of movement quality (indexed by duration and smoothness) measured using a motion tracking system when performing a standardized computer task.
Results: The system was used for a median time of 75 min (interquartile range (IQR) 17–271), equating to 606 outward and 734 inward movements. Pre-COPM, (median 4.2); post-COPM (median 6.0); obs = 34; z = 3.62, p < 0.01). Kinematic analysis of pre- and post-intervention movements on the standardized task showed decreased duration and increased smoothness.
Conclusion: Some improvements in self-reported function and quality of movement are observed. This pilot study suggests that the system could be used to augment home-based arm exercise in an engaging way for children with cerebral palsy, although a controlled clinical trial is required to establish clinical efficacy. The feasibility of this technology has been demonstrated.
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