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Participation and community-based walking activity after neuroprosthesis use in children with hemiplegic cerebral
Amy F Bailes1,2, Cailee Caldwell1, Mike Clay1
1Division of Occupational Therapy and Physical Therapy, University of Cincinnati, Cincinnati, OH, USA.
Insights
Daily use of neuroprosthesis improved participation and reduced trips in children with hemiplegic cerebral palsy (CP). Community walking activity did not significantly change, but satisfaction with the device was high.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pediatric Orthopedics
Background:
- Hemiplegic cerebral palsy (CP) often impacts community ambulation and participation.
- Neuroprosthetic devices offer a potential avenue to enhance motor function and independence.
Purpose of the Study:
- To evaluate the impact of neuroprosthesis use on participation, community walking activity, safety, and satisfaction in children with hemiplegic CP.
- To assess changes in self-selected participation goals and walking activity levels.
Main Methods:
- A 16-week intervention study involving eleven children (mean age 9y 11mo) with hemiplegic CP (GMFCS Levels I-II).
- Utilized the Ness L300 neuroprosthesis, measuring outcomes with the Canadian Occupational Performance Measure (COPM), Step Watch Activity Monitor (SAM), and caregiver-reported trip/fall frequency.
- Assessed satisfaction through a dedicated questionnaire.
Main Results:
- Significant improvements (p<0.001) in performance and satisfaction with participation goals (COPM).
- A significant reduction (p=0.01) in reported trips from baseline to post-intervention.
- High levels of satisfaction reported with the neuroprosthesis device.
Conclusions:
- Daily neuroprosthesis use may enhance participation goal achievement and reduce tripping incidents in children with hemiplegic CP.
- No significant changes were observed in community-based walking activity levels.
- Further research is recommended to explore responses based on GMFCS levels, geographical variations, and comparisons with functional electrical stimulation (FES) neuroprostheses and control groups.
Purpose:
To explore the effects of neuroprosthesis use on participation, level of community-based walking activity, safety and satisfaction in children with hemiplegic CP.
Methods:
Eleven children (mean 9 years 11 months) with hemiplegic CP Gross Motor Function Classification System (GMFCS) Level I and II participated in a 16-week intervention using the Ness L300 neuroprosthesis. Outcome measures included satisfaction and performance with self-selected participation goals (Canadian Occupational Performance Measure (COPM)), level of community-based walking activity (Step Watch Activity Monitor (SAM)), trip and fall frequency (caregiver report) and a satisfaction questionnaire.
Results:
Significant (p< 0.001) improvements in performance and satisfaction with self-selected participation goals (COPM) were demonstrated. No significant changes were noted in SAM values. A significant (p= 0.01) decrease in trips was demonstrated from baseline to post. Satisfaction with the device was high.
Conclusion:
Results indicate that daily neuroprosthesis use may improve performance and satisfaction with participation goals and reduce trips. No changes in community-based walking activity were noted. Further study is needed to examine response based on GMFCS levels, across geographical regions and between FES neuroprosthesis and a control group.
