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Effect of task context on reaching performance in children with spastic hemiparesis
M J M Volman1, A Wijnroks, Adri Vermeer
1Utrecht University, Institute for the Study of Education and Human Development, Faculty of Social Sciences, The Netherlands. m.volman@fss.uu.nl
Objective:
To investigate the effect of task context on the quality of reaching movements in children with spastic hemiparesis.
Design:
Randomized controlled experimental trial.
Setting:
Institute for the Study of Education and Human Development (ISED).
Subjects:
Twelve children (8-14 years of age) with spastic hemiplegic cerebral palsy.
Interventions:
Subjects made fast reaching movements with the affected or nonaffected arm on a digitizer in three context conditions: (a) reach to press a light switch to turn on a red light (functional), (b) reach to press the light switch; no light (semi-functional), and (c) reach to a marker (nonfunctional).
Main Outcome Measures:
Kinematics of reaching movements of affected and nonaffected arms: movement time (MT), peak velocity (PV), time to PV, percentage of MT where peak velocity occurred (PPV), and smoothness (i.e. number of movement units (MU)).
Results:
The functional condition elicited better quality of reaching for the nonaffected, but particularly the affected arm. Reaching of the affected arm was faster (larger MT; F = 10.21, p < 0.01), smoother (fewer MU; F = 19.95, p < 0.001), and better-controlled (right shift of PPV; F = 16.03, p < 0.001) compared with the semi- and nonfunctional condition. Reaching of the nonaffected arm was also faster (longer MT, F = 4.81, p < 0.05), and more smooth (fewer MU, F = 7.23, p < 0.05).
Conclusions:
These findings suggest that providing a functional context to perform a task may enhance the quality of reaching movements of the affected arm in children with spastic hemiparesis.