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Does somatosensory discrimination therapy alter sensorimotor upper limb function differently compared to motor
Lize Kleeren1,2,3, Lisa Mailleux4,5, Belinda McLean6,7
1KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium. lize.kleeren@kuleuven.be.
Insights
This study compares somatosensory discrimination therapy to motor therapy for children with unilateral cerebral palsy (uCP). Results may guide effective upper limb therapy selection for those with tactile impairments.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pediatrics
Background:
- Unilateral cerebral palsy (uCP) significantly impacts children, with up to 90% experiencing upper limb somatosensory deficits.
- These deficits compromise motor control and learning, hindering daily activities.
- Targeted interventions for somatosensory impairments in pediatric uCP are under-researched.
Purpose of the Study:
- To compare the efficacy of somatosensory discrimination therapy versus dose-matched motor therapy.
- To improve sensorimotor upper limb function in children and adolescents with uCP and somatosensory impairments.
- To identify predictors of therapy response.
Main Methods:
- A randomized controlled trial (RCT) involving 50 children (7-15 years) with uCP.
- Participants receive 8 weeks of either somatosensory or motor therapy (3x45 min/week).
- Evaluations include bimanual performance (primary), somatosensory function, motor skills, and brain imaging.
Main Results:
- This section will be updated once the study is completed and results are available.
Conclusions:
- This RCT protocol outlines a comparison between somatosensory discrimination and motor therapy for pediatric uCP.
- Findings are expected to inform optimal upper limb therapeutic strategies for individuals with tactile deficits.
Background:
Besides motor impairments, up to 90% of the children and adolescents with unilateral cerebral palsy (uCP) present with somatosensory impairments in the upper limb. As somatosensory information is of utmost importance for coordinated movements and motor learning, somatosensory impairments can further compromise the effective use of the impaired upper limb in daily life activities. Yet, intervention approaches specifically designated to target these somatosensory impairments are insufficiently investigated in children and adolescents with uCP. Therefore, the aim of this randomized controlled trial (RCT) is to compare the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP, who experience somatosensory impairments in the upper limb. We will further explore potential behavioral and neurological predictors of therapy response.
Methods:
A parallel group, evaluator-blinded, phase-II, single-center RCT will be conducted for which 50 children and adolescents with uCP, aged 7 to 15 years, will be recruited. Participants will be randomized to receive 3 weekly sessions of 45 minutes of either somatosensory discrimination therapy or upper limb motor therapy for a period of 8 weeks. Stratification will be performed based on age, manual ability, and severity of tactile impairment at baseline. Sensorimotor upper limb function will be evaluated at baseline, immediately after the intervention and after 6 months follow-up. The primary outcome measure will be bimanual performance as measured with the Assisting Hand Assessment. Secondary outcomes include a comprehensive test battery to objectify somatosensory function and measures of bimanual coordination, unimanual motor function, and goal attainment. Brain imaging will be performed at baseline to investigate structural brain lesion characteristics and structural connectivity of the white matter tracts.
Discussion:
This protocol describes the design of an RCT comparing the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP. The results of this study may aid in the selection of the most effective upper limb therapy, specifically for children and adolescents with tactile impairments.
Trial Registration:
ClinicalTrials.gov (NCT06006065). Registered on August 8, 2023.
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