Intensive body weight-supported treadmill training may be an effective intervention for some children with CP who are ambulatory.

No abstract

Manual wheelchair users commonly experience pain in their hands and wrists associated with the repetitive stress of propulsion. The objective of this research was to examine the effect of an ergonomic wheelchair handrim as an intervention designed to reduce pain in the hands and wrists and improve functional outcomes for manual wheelchair users. Three studies were conducted to achieve this objective. In the first study, 10 individuals with paraplegia underwent a biomechanical analysis before and after a 2-week practice period with a Natural-Fit (NF) prototype ergonomic handrim. The biomechanical results showed that grip moments were reduced with the NF handrim prototype as compared with the subjects' current handrim (p < .1). Other biomechanical findings were mixed. In the second study, 46 manual wheelchair users who replaced their standard handrim with the commercially available NF handrim completed a questionnaire of retrospective measures of symptom severity. Average duration of use of the NF was 6 months. When asked to compare propelling with the NF to propelling with their prior handrims, 85% of respondents reported less pain in their hands and 80% reported less pain in their wrists. The third study was a replication and extension of Study 2: 82 manual wheelchair users who replaced their standard handrim with the NF completed retrospective symptom severity and functional status scales after using the NF for an average of 9 months. Results again confirmed that using the NF led to a reduction in the severity of symptoms and to improved functional outcomes.

The purposes of this study were to compare dexterity, visual perception, and abilities to carry out activities of daily living (ADL) in persons with different multiple sclerosis (MS) subtypes and to determine what relationships exist between the three variables. Fifty-six persons with MS were administered tests of dexterity, visual perception, and ADL ability. Demographic variables and scores on Kurtzke's Expanded Disability Status Scale were also collected. Scores from the chronic-progressive group were significantly higher than those of the benign and progressive-relapsing groups for the Nine-Hole Peg Test-Left Hand, Grooved Peg Test, and Functional Status Index (except Functional Status Index-Pain). There were no differences between the MS groups for any demographic variables except on the Expanded Disability Status Scale. Visual perception did not correlate with dexterity or ADL ability, and only dexterity scores for the left hand correlated with ADL ability. Persons with the severer subtype of MS were significantly impaired compared with the least severe group for dexterity and ADL ability. Decreased dexterity was associated with needing more assistance and having more perceived difficulty with ADL.

Results suggest that positive health-related quality of life changes can be identified after an intensive intervention of BWSTT, and should include ratings from both children and parents.