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Hand-Arm Bimanual Intensive Therapy Improves Prefrontal Cortex Activation in Children With Hemiplegic Cerebral Palsy

Swati M Surkar1, Rashelle M Hoffman, Sandra Willett

  • 1Department of Physical Therapy (Drs Surkar, Hoffman, and Kurz and Ms Willett) and Department of Occupational Therapy (Ms Flegle), Munroe Meyer Institute of Genetics and Rehabilitation, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, Nebraska; Department of Physical Therapy (Dr Harbourne), John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania.

Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association
|March 27, 2018
PubMed

Insights

Hand-arm bimanual intensive therapy (HABIT) reduced prefrontal cortex (PFC) activation in children with hemiplegic cerebral palsy (HCP). This therapy improved motor skills and brain function, bringing PFC activation closer to typically developing children.

Area of Science:

  • Neuroscience
  • Pediatric Rehabilitation
  • Developmental Motor Disorders

Background:

  • Hemiplegic cerebral palsy (HCP) affects motor function in children.
  • Prefrontal cortex (PFC) plays a role in motor control and planning.
  • Hand-arm bimanual intensive therapy (HABIT) is a therapeutic approach for improving upper extremity function.

Purpose of the Study:

  • To investigate changes in PFC activation after HABIT in children with HCP.
  • To compare PFC activation in children with HCP to typically developing (TD) children.
  • To correlate PFC activation changes with motor skill improvements.

Main Methods:

  • Nine children with HCP received 50 hours of HABIT.
  • Functional near-infrared spectroscopy (fNIRS) measured PFC activation pre- and post-therapy.
  • Motor assessments included the Assisting Hand Assessment (AHA), shape matching, reaction time, 9-hole peg test, and box and blocks test.

Main Results:

  • PFC activation decreased in children with HCP after HABIT.
  • Post-HABIT PFC activation levels in children with HCP became comparable to TD children.
  • Improvements in PFC activation correlated with enhanced performance on the AHA and other behavioral motor tasks.

Conclusions:

  • HABIT may enhance PFC involvement in planning upper extremity movements for children with HCP.
  • Therapeutic interventions can modulate brain activity in children with cerebral palsy.
  • HABIT shows promise in improving both motor function and neural correlates of motor control.
Abstract

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