TY - JOUR
T1 - A multi-site study of functional outcomes following a themed approach to hand-arm bimanual intensive therapy for children with hemiplegia
AU - Green, Dido
AU - Schertz, Mitchell
AU - Gordon, Andrew M.
AU - Moore, Amarlie
AU - Schejter Margalit, Tamara
AU - Farquharson, Yvonne
AU - Ben Bashat, Dafna
AU - Weinstein, Maya
AU - Lin, Jean Pierre
AU - Fattal-Valevski, Aviva
PY - 2013/6
Y1 - 2013/6
N2 - Aim: This study investigated the effects of a theme-based ('magic') variation of the hand-arm bimanual intensive therapy programme, in two different countries, in improving activity performance for children with hemiplegia, including those with severe movement restrictions. Method: Twenty-three children with spastic hemiplegia (13 males, 10 females; mean age 10y 7mo, range 7-15y; Manual Ability Classification System level I, two; level II, 13; level III, eight), participated in one of three, 2-week, summer camps. A within-participant experimental design was used with the Assisting Hand Assessment and Children's Hand Experience Questionnaire as primary outcome measures. Evaluations occurred immediately before the first day, on the last day, and 3 months after intervention. Two groups underwent additional assessments 2 weeks before the camp. Results: Significant intervention effects were seen on the Assisting Hand Assessment (p=0.002) and on the Children's Hand Experience Questionnaire (p<0.001), the latter maintained at follow-up. The affected hand was reported to be used in 25% of bimanual activities before the camp, progressing to 93% after camp, and decreasing to 86% at follow-up. Severity of impairment did not influence progress. Interpretation: This themed approach to intensive intervention showed positive results in bimanual use, with improvements in independence sustained at follow-up. Although children across camps and motor severity made progress, some questions remain about intensity and duration of intervention to optimize longer-term outcomes.
AB - Aim: This study investigated the effects of a theme-based ('magic') variation of the hand-arm bimanual intensive therapy programme, in two different countries, in improving activity performance for children with hemiplegia, including those with severe movement restrictions. Method: Twenty-three children with spastic hemiplegia (13 males, 10 females; mean age 10y 7mo, range 7-15y; Manual Ability Classification System level I, two; level II, 13; level III, eight), participated in one of three, 2-week, summer camps. A within-participant experimental design was used with the Assisting Hand Assessment and Children's Hand Experience Questionnaire as primary outcome measures. Evaluations occurred immediately before the first day, on the last day, and 3 months after intervention. Two groups underwent additional assessments 2 weeks before the camp. Results: Significant intervention effects were seen on the Assisting Hand Assessment (p=0.002) and on the Children's Hand Experience Questionnaire (p<0.001), the latter maintained at follow-up. The affected hand was reported to be used in 25% of bimanual activities before the camp, progressing to 93% after camp, and decreasing to 86% at follow-up. Severity of impairment did not influence progress. Interpretation: This themed approach to intensive intervention showed positive results in bimanual use, with improvements in independence sustained at follow-up. Although children across camps and motor severity made progress, some questions remain about intensity and duration of intervention to optimize longer-term outcomes.
UR - http://www.scopus.com/inward/record.url?scp=84876865303&partnerID=8YFLogxK
U2 - 10.1111/dmcn.12113
DO - 10.1111/dmcn.12113
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C2 - 23458353
AN - SCOPUS:84876865303
SN - 0012-1622
VL - 55
SP - 527
EP - 533
JO - Developmental Medicine and Child Neurology
JF - Developmental Medicine and Child Neurology
IS - 6
ER -