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Effect of Home-based Bimanual Training in Children with Unilateral Cerebral Palsy (The COAD-study): A Case Series
Lwme Beckers1,2, Eaa Rameckers1,2,3, Pbm Aarts4
1Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Insights
Home-based bimanual training shows promising results for children with unilateral cerebral palsy. The program improved children's bimanual goals, though some parents experienced stress due to training intensity.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Occupational Therapy
Background:
- Unilateral cerebral palsy (UCP) affects motor function in children.
- Bimanual training is crucial for improving upper limb function in UCP.
- Home-based interventions offer accessibility and potential for increased practice.
Purpose of the Study:
- To evaluate the effects of a home-based bimanual training program on children with UCP.
- To assess both child-related functional outcomes and parent-related outcomes, such as stress.
- To compare implicit versus explicit motor learning approaches within the training.
Main Methods:
- A case series of 14 children (2-7 years) with UCP participated.
- The program involved goal-oriented, task-specific bimanual training for 12 weeks.
- Parents received coaching from a therapist and educationalist; outcomes measured by the Canadian Occupational Performance Measure (COPM) and parental interviews.
Main Results:
- Clinically relevant improvements in bimanual goal performance (COPM) were observed in a high percentage of children (50% at T1, 86% at T2, 85% at T3).
- Some parents reported stress related to the intensity of the home-based training program.
- Both implicit and explicit motor learning approaches were utilized.
Conclusions:
- Home-based bimanual training demonstrates encouraging child-related functional benefits for children with UCP.
- Parental stress is a factor to consider in the implementation of intensive home-based programs.
- The findings support the feasibility and positive impact of such interventions.
Abstract:
: To explore the child- and parent-related effects of home-based bimanual training in children with unilateral cerebral palsy.: Case series of 14 children (2-7 years) who completed goal-oriented task-specific training for 3.5 hours/week for 12 weeks by a program adopting implicit (n = 5) or explicit (n = 9) motor learning. A therapist and remedial educationalist coached parents. Progression on bimanual goals (Canadian Occupational Performance Measure (COPM)) and therapy-related parental stress (interviews) were of primary interest. Data were collected at baseline (T0), halfway through and at the end of training (T1 and T2), and after 12 weeks (T3).: On the COPM performance scale a clinically relevant change was seen in 50% (7/14), 86% (12/14), and 85% (11/13) of the children, at T1, T2, and T3, respectively. Some parents indicated that they had experienced stress because of the training intensity.: The child- and parent-related effects of the home-based bimanual training programs are encouraging.
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