Effect of Home-based Bimanual Training in Children with Unilateral Cerebral Palsy (The COAD-study): A Case Series

Abstract

Purpose: To explore the child-and parent-related effects of home-based bimanual training in children with unilateral cerebral palsy. Methods: Case series of 14 children (2-7 years) who completed goal-oriented task-specific training for 3.5 hours/ week for 12 weeks by a program adopting implicit (n = 5) or explicit (n = 9) motor learning. A therapist and remedial educationalist coached parents. Progression on bimanual goals (Canadian Occupational Performance Measure (COPM)) and therapy-related parental stress (interviews) were of primary interest. Data were collected at baseline (T0), halfway through and at the end of training (T1 and T2), and after 12 weeks (T3). Results: On the COPM performance scale a clinically relevant change was seen in 50% (7/14), 86% (12/14), and 85% (11/13) of the children, at T1, T2, and T3, respectively. Some parents indicated that they had experienced stress because of the training intensity. Conclusion:The child-and parent-related effects of the home-based bimanual training programs are encouraging.

Feasibility of a Home-Based Mirror Therapy Program in Children with Unilateral Spastic Cerebral Palsy

“…During the video calls, some families only reported some fatigue in children when performing the therapy. Other studies also found no adverse events in MT or home-based programs for children with US CP [28,36,38].…”

“…Other studies with different home-based interventions used other ways to coach families. Some of them used webcam-monitoring during the performance of the intervention [ 60 ], while others maintained weekly phone calls and home visits [ 27 , 28 ].…”

“…Different home-based approaches for children with US CP have demonstrated their feasibility in terms of acceptability and safety [ 20 , 26 , 27 , 28 , 29 ].…”

A New Training Protocol Based on Bimanual Playing a Computer Game for Motion-Cognitive Rehabilitation in Children with Spastic Hemiparetic Cerebral Palsy

“…Hemiparesis is defined as unilateral motor disability resulting from brain injury, wherein one side of the body is more significantly affected than the other (3). In hemiparetic CP, the upper extremities may suffer more severe impairments than the lower parts (4). Such upper limb disorders can significantly limit a child's ability to engage in daily activities and lead a normal life (5).…”