Immediate effects of a novel hand rehabilitation board on fine motor skills in children with cerebral palsy: A pilot study.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY NeuroRehabilitation Pub Date : 2024-01-01 DOI:10.3233/NRE-230286

Amitesh Narayan, Abraham M Joshua, Romita Fernandes, Shreekanth D Karnad, Abdulaziz Alammari, Namrata S Chauhan, Mohand Taleb D Almgamese

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Abstract

Background: In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills.

Objective: This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities.

Methods: The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49-72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded.

Results: The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively.

Conclusion: The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.

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新型手部康复板对脑瘫儿童精细运动技能的直接影响：试点研究

背景：脑性瘫痪（CP）儿童的精细运动技能限制了前臂上举和肘部、腕部或手指的主动伸展。治疗干预的重点是改善这些关节的活动范围，同时促进主动运动，这是增强精细运动技能的关键：本试验性研究将探讨接受 "新颖手部康复"（NHR）板治疗的 CP 儿童（涉及 UE）是否会表现出：1）前臂和手腕/手指肌肉痉挛和被动 ROM 的变化；2）精细运动能力的改善：方法：将年龄在 49-72 个月（65.33±6.355 个月）的痉挛性脊柱侧索硬化症患儿（N = 15；M = 7，F = 8）的前臂和腕/指放置在 NHR 板上，直至其耐受极限或至少持续 30 分钟。记录结果指标，即痉挛（改良阿什沃斯量表）、手腕和手指被动运动范围（PROM）以及精细运动技能（PDMS-2 - 精细运动量表）：结果：前臂前伸肌（0.001）和腕关节屈肌（0.008）的痉挛程度明显减轻，但腕关节伸肌的痉挛程度没有减轻。干预后，腕关节伸展（p = 0.005）和尺侧偏离ROM（p = 0.007）有明显改善。在拇指方面，CMC屈曲的变化不明显，但伸展（0.003）和外展（0.001）以及MCP伸展（0.004）的变化明显。干预后，第 2 指（0.001）、第 3 指（0.007）和第 4 指（0.014）的 MCP 伸展 ROM 也有大幅变化，但 PIP 和 DIP 关节的变化不大。干预后，PDMS-2 的抓握和视觉运动整合分测验的百分比变化分别为 11.03% (p = 0.002) 和 5.09% (p = 0.001)：应用 NHR 板后，CP 儿童的精细运动技能立即得到了积极和令人鼓舞的改善。因此，可以推荐使用 NHR 板作为干预措施，以改善脊髓灰质炎儿童的精细动作能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NeuroRehabilitation CLINICAL NEUROLOGY-REHABILITATION

CiteScore

3.20

自引率

0.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： NeuroRehabilitation, an international, interdisciplinary, peer-reviewed journal, publishes manuscripts focused on scientifically based, practical information relevant to all aspects of neurologic rehabilitation. We publish unsolicited papers detailing original work/research that covers the full life span and range of neurological disabilities including stroke, spinal cord injury, traumatic brain injury, neuromuscular disease and other neurological disorders. We also publish thematically organized issues that focus on specific clinical disorders, types of therapy and age groups. Proposals for thematic issues and suggestions for issue editors are welcomed.