SUMMARY Eleven subjects with cerebral palsy were assessed both with the Melbourne Assessment and by four clinical experts. Comparison of their assessment ratings revealed that the Melbourne Assessment was strongly related to the clinical judgement of the experts. A further 20 subjects were administered the Melbourne Assessment and two occupational therapists scored each subject's performance from videotaped assessments with substantial inter‐rater reliability (0–68); intra‐rater agreement after two weeks was 0–80. The Melbourne Assessment may provide a satisfactory objective measure of the quality of upper‐limb function. RÉSUMÉ Mise en place d'une évaluation clinique de qualité de mouvement dans la fonclion unilatéral du membre supérieur Onze IMC ont étéévalués par le Melbourne Assessement et quatre experts cliniques. La confrontation de leurs évaluations a montré que le Melbourne Assessement était fortement relié au jugement clinique des experts. 20 autres sujets furent évalués à partir de bandes vidéo par le Melbourne Assessement et deux ergothérapeutes, avec une bonne fidélité inter‐examinateur (0–68) et un accord intra‐examinateur de 0–80. Le Melbourne Assessement peut fournir une mesure objective de la qualité de la fonction du membre supérieur. ZUSAMMENFASSUNG Klinische Beurteilung der Bewegungsqualität bei unilateraler Funktion der oberen Extremitat 11 Patienten mit Cerebralparese wurden anhand der Melbourne Assessment, sowie von vier klinischen Experteh untersucht. Der Vergleich ihrer Beurieilungen zeigte, daß die Ergebnisse der Melbourne Assessment klar mit den Befunden der Experten korrelierten. Weitere 20 Patienten wurden mit der Melbourne Assessment getestet und zwei Beschäftigungsthcrapeuten beurteilten die Leistungen jedes Patienten anhand von Videoaufnahmen mit einer erstaunlichen Inter‐Rater Übereinstimmung (0–68); die Inter‐Rater Übereinstimmung nach zwei Wochen betrug 0–80. Die Melbourne Assessment mag eine zufriedenstellende objektive Methode zur Beurteilung der Bewegungsqualitat der oberen Exiremität sein. RESUMEN Desarrollo du una evaluación cli'nica de la calidad de movimiento en la extremidad su perior unilateral Once individuos con parálisis cerebral fueron evaluados por medio de la Evaluación de Melbourne y por cuatro expertos clinicos. La comparación de sus evaluaciones reveló que la Evaluación de Melbourne estaba fuertemente corelacionada con el juicio clinico de los expertos. A otros 20 individuos se les pasó la Evaluación de Melbourne y dos terapeutas ocupacionales puntuaron la realización de cada individuo a partir de cintas de video con una fiabilidad entre los promedios substancial. La coincidencia tras dos semanas era de 0,80. La Evaluación Melbourne puede proporcionar una medición objetiva satisfactoria de la calidad de la función de la extremidad superior.
Student and school success was impacted substantially by the capacity of adults in the student's life to collaborate - family, school professionals and allied health practitioners. An inclusive school culture was crucial to students with cerebral palsy. All parties needed to prioritize promotion of an open and positive school culture built around problem-solving inclusive practices. Involved people, such as allied health practitioners, bring knowledge and skills that are not otherwise readily available in school environments. Implications for rehabilitation Students with cerebral palsy have high needs at school and allied health practitioners have a role advocating for, educating and providing support to students within the school. Teachers of students with cerebral palsy need education, training and support from allied health practitioners. The need for allied health and rehabilitation services continues for children and youth with cerebral palsy outside of school and across the schooling years. School professionals; allied health practitioners; families and students can work together to improve the student experience.
Little is known about sensation in children with upper limb congenital deficiencies. Is sensation different in the deficient limb? If so, does sensation influence function and determine whether or not a prosthesis is used? This study was undertaken to measure sensation in children with transradial congenital limb deficiencies and to explore possible associations with function and prosthetic use. Twenty-four children and adolescents were evaluated on touch pressure and kinaesthesia measurement tools. The participants' parents were required to rate their child's performance on everyday functional activities and, where appropriate, report on their child's patterns of prosthetic use. The results revealed that most participants had better touch pressure sensation at the stump circumference of the deficient limb, not only compared with the same level on the intact limb (p = 0.06) but also compared with the hand (p = 0.008). All the participants demonstrated perfect scores for kinaesthetic awareness for both limbs. No strong association was found between touch pressure and performing functional activities or prosthetic use patterns. This study is an important contribution to understanding upper limb sensation in children with congenital limb deficiencies and the implications for function and prosthetic use. Further research involving multiple centres would provide an adequate sample size to explore more fully sensation in children with congenital upper limb deficiencies and its possible association with function and prosthetic use.
SUMMARY The outcome of an eight‐week period of additional occupational therapy, aimed at improving fine motor skills, was assessed by accelerometry and a rating scale based on the Erhardt Developmental Prehension Assessment. 10 children with cerebral palsy received their regular occupational therapy, while a similar group had an additional 30‐minute session each day. No difference was found between groups at the end of the study. The difficulties of designing this type of project are discussed and the assessment methods described. RÉSUMÉ Mesures subjectives et objectives pour étudier le résultat de traitements supplémentaires chez les enfants avec IMC Le résultat d'une période du huit semaines d'une rééducation ergothérapique supplémentaire visant à améliorer l'activité motrice fine a été appréciée par Developmental Prehension Assessment. 10 enfants IMC bénefiérent d'un traitement d'ergothérapie habituelle tandis qu'un groupe semblable bénéficiat d'une session supplémentaire de 30 minutes chaque jour. Aucune difference n'a été notée entre les groupes à la fin de l'étude. Les difficultés pour établir ce type de projet sont discutées et les méthodes d'évaluation sont décrites. ZUSAMMENFASSUNG Subjetive und objektive Beurteilung des Erfolgs einer zusätzlichen Therapie bei Kindern mit Cerebralparese Der Erfolg einer zusätzlichen Beschäftigungstherapie über den Zeitraum von acht Wochen, mit dem Ziel, die Feinmotorik zu verbessern, wurde mit Hilfe der Akzelerometrie und einer Einstufung nach der Erhardt Developmental Prehension Assessment beurteilt. 10 Kinder mit Cerebralparese erhielten ihre regelmäßige Beschäftigungstherapie, während eine entsprechende Gruppe täglich zusätzlich 30 Minuten behandelt wurde. Am Ende der Studie fand sich kein Unterschied zwischen den Gruppen. Die Schwierigkeiten der Planung eines solchen Projektes werden diskutiert und die Methoden der Beurteilung werden beschrieben. RESUMEN Medidas subjetivas y objetivas para estudiar el curso de una terapia adicionel en niños con parálisis cerebral Se evaluó el curso seguido durante un periodo de ocho semanas de terapia ocupacional adicionada que pretendia mejorar la motilidad fina. Se utilizó la acelerometría y una escala de proporción basada en el Erhardt Developmental Prehension Assessment. 10 niños con parálisis cerebral recibieron su terapia ocupacional habitual, mientras que un grupo similar recibia una sesión añadida de 30 minutos cada dia. No se halló ninguna diferencia entre ambos grupos al final de este estudio. Se discuten las dificultades para el diseño de este tipo de proyecto y se describen los métodos de evaluaciön.
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