Effect of task-oriented training and high-variability practice on gross motor performance and activities of daily living in children with spastic diplegia

Abstract

[Purpose] This study investigates how a task-oriented training and high-variability practice program can affect the gross motor performance and activities of daily living for children with spastic diplegia and provides an effective and reliable clinical database for future improvement of motor performances skills. [Subjects and Methods] This study randomly assigned seven children with spastic diplegia to each intervention group including that of a control group, task-oriented training group, and a high-variability practice group. The control group only received neurodevelopmental treatment for 40 minutes, while the other two intervention groups additionally implemented a task-oriented training and high-variability practice program for 8 weeks (twice a week, 60 min per session). To compare intra and inter-relationships of the three intervention groups, this study measured gross motor performance measure (GMPM) and functional independence measure for children (WeeFIM) before and after 8 weeks of training. [Results] There were statistically significant differences in the amount of change before and after the training among the three intervention groups for the gross motor performance measure and functional independence measure. [Conclusion] Applying high-variability practice in a task-oriented training course may be considered an efficient intervention method to improve motor performance skills that can tune to movement necessary for daily livelihood through motor experience and learning of new skills as well as change of tasks learned in a complex environment or similar situations to high-variability practice.

Effects of task-oriented activities based on neurodevelopmental therapy principles on trunk control, balance, and gross motor function in children with spastic diplegic cerebral palsy: A single-blinded randomized clinical trial

“…Task-oriented activities in different planes through hands on were favorable in facilitating typical movement patterns, thereby improving the trunk control, posture, and gross motor function. [33] Similar findings were reported by Labaf et al ,[18] Fetters and Kluzik,[34] Akbari et al ,[35] and Tsorlakis et al [15] who reported that the use of NDT in children with CP improved their gross motor function and daily activities. Park[36] investigated the effect of physical therapy frequency based on NDT on gross motor function in children with CP in South Korea for 1 year and concluded that intensive physical therapy was more effective for improving gross motor function such as crawling, kneeling, and standing.…”

“…Similarly, Kwon and Ahn[33] reported a greater improvement in GMFM and balance with task-oriented training in children with CP. This proves that truncal stability is an essential core component of balance and coordinated extremity use in daily functional activities and performance of higher level motor tasks.…”

“…Gross motor function has been related to functional outcomes such as activities of daily living. [33] A greater improvement with a large effect size of 1.9 in the gross motor function was observed in the TOA-NDT group compared to that in the CPT group. This indicates improved capabilities in the performance of gross motor skills by the children in TOA-NDT group.…”

Gait alterations during walking with partial body weight supported on a treadmill and over the ground

“…In terms of functionality, variability during gait practice is desirable and necessary for adaptability 31 . If more variabilities during practice are considered to lead to better retention and transfer to different contexts 32 and consequently, motor learning 33,34 , the use of a BWS system over the ground would provide more benefits than that on a treadmill for (re)learning and/or reestablishing gait in individuals with gait impairment.…”

One‐year follow‐up of problem‐based task training for a child presenting cerebellar ataxia after brainstem glioma surgery: A single‐subject experimental study

“…Therefore, for the rehabilitation of patients with cerebellar ataxia, there is consensus that task training aids in achieving functional benefits. In previous studies, the positive effects of training on mobility and coordination in children with cerebellar ataxia have been reported (Kwon et al, 2014).…”