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The effect of computerized tracking training on upper limb coordination in children with hemiplegic cerebral palsy: a case series study
Author(s) -
H Chiu
Publication year - 2016
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.08_13225
Subject(s) - cerebral palsy , physical medicine and rehabilitation , medicine , lower limb , series (stratigraphy) , physical therapy , psychology , surgery , biology , paleontology
Background and Objective(s): Previous study has shown that coordination of motor impairments (coordination, weakness, contracture and spasticity) made a large contribution to upper limb activity in people with hemiplegic cerebral palsy. Therefore, the objective of this study was to examine whether computerized tracking training through elbow flexion/extension could improve upper limb coordination in children with hemiplegic cerebral palsy. Study Design: A case series A-B-A multiple baseline design was used. After a baseline observation (Phase A), and a 2-week intervention of coordination training (Phase B) was conducted followed by a 2-week follow-up (Phase A). Study Participants & Setting: Four children (age range 8–12y, girls) with hemiplegic cerebral palsy with level I or II of Manual Ability Classification System (MACS) were recruited from mainstream school. Materials/Methods: Computerized tracking training was a visual pursuit tracking which required the participants to track the movements of a target on a computer screen using elbow joint flexion and extension. The participant with the forearm supported on a table with an electrogoniometer attached to the forearm and upper arm. The target moved irregularly back and forth with the frequency of target at either 0–0.6 or 0–0.8 Hz across the computer screen. The signal from the electrogonimeter during elbow flexion and extension drove the response cursor via 55–65 degree of elbow flexion. A maximum of 109 1-minute trials were practiced each session covering two target frequencies. Coordination was measured through tracking performance using a different target from intervention with the frequency between 0 and 0.8 Hz. Tracking performance was compared the similarity between the target and the response, and was recorded as overall coherence with 1.0 representing a perfect score. Data were analyzed using visual inspection and then statistical analyses were performed to support the visual findings using the 2-SD band method. Results: The 10 intervention sessions were carried out at the participants’ home. Only one participant appeared improvement in coordination during follow-up phase both visually and statically (p<0.05) (Finger 1a). There was no significant difference between intervention and baseline (p>0.05) as well as between follow up and baseline (p>0.05) using the 2-SD band method (Figure 1b–d).