An Instrumentation Approach for Assessing the Effects of a Hand Positioning Device on Reaching Motion of Children with Cerebral Palsy

Abstract

The effects of a hand positioning device (HPD) on the quality of upper-extremity movement of five children with cerebral palsy were examined in this pilot study. Hand position was monitored during a reaching task using a single-point, 3°-of-freedom, three-dimensional tracker device. Three-dimensional path length, average velocity, movement time, response time, and the number of accelerations and decelerations (movement units) were measured. Operational definitions for each of these variables were developed for this study. Each subject performed 15 reaching trials at a pretest and posttest. A 6-week intervention period followed the pretest where each subject wore the HPD for 1 hour daily for functional activities. Group results showed no significant differences for any of the variables being measured. However, individual data analysis revealed that the HPD has the potential for modifying the quality of reaching motions in some children with cerebral palsy. The nature of the changes observed among these five subjects is discussed, as well as suggestions for future research studies. Finally, this initial study shows that the tracker is a sensitive method for recording qualitative changes in the upper-extremity motion of children with cerebral palsy in occupational therapy research.

Keywords

motion analysis measurement upper extremity

Get full access to this article

View all access options for this article.

References

Bobath

(1980). A neurophysiological basis for the treatment of cerebral palsy London: William Heinemann Medical Books Ltd.

Bobath

, & Bobath

(1964). The facilitation of normal postural reactions and movements in the treatment of cerebral palsy. Physiotherapy, 50, 246–262.

Boehme

(1990). Developing mid-range control and function in children with fluctuating muscle tone. Tuscon: Therapy Skill Builders.

Casey

C. A.

, & Kratz

E. J.

(1988). Soft splinting with neoprene: The thumb abduction supinator splint. American Journal of Occupational Therapy, 42, 395–398.

Chandler

L. S.

Andrews

S. A.

, & Swanson

M. W.

(1980). Movement assessment of infants: A manual. Rolling Bay, WA: P.O. Box 4631.

Currie

D. M.

, & Mendiola

(1987). Cortical thumb orthosis for children with spastic hemiplegic cerebral palsy. Archives of Physical Medicine and Rehabilitation, 68, 214–216.

Exner

C. E.

, & Bonder

B. R.

(1983). Comparative effects of three hand splints on bilateral hand use, grasp, and arm-hand posture in hemiplegic children: A pilot study. Occupational Therapy Journal of Research, 3, 75–92.

Hill

S. G.

(1988). Current trends in upper-extremity splinting. In Boehme

(Ed.), Improving upper body control (pp. 131–164). Tucson: Therapy Skill Builders.

Kluzik

Fetters

, & Coryell

(1990). Quantification of control: A preliminary study of effects of neurodevelopmental treatment on reaching in children with spastic cerebral palsy. Physical Therapy, 70, 65–76.

10.

Landnesser

W. E.

McCrum

R. C.

, & Allen

J. C.

(1955). The opponens spacer: A device to facilitate opposition in the hand of the cerebral palsied or hemiplegic child. American Journal of Occupational Therapy, 19, 112–114.

11.

MacKinnon

Sanderson

, & Buchanan

(1975). The MacKinnon splint: A functional hand splint. Canadian Journal of Occupational Therapy, 42, 157–158.

12.

McPherson

J. J.

Schild

Spaulding

Barsamian

Transon

, & White

S. C.

(1991). Analysis of upper extremity movement in four sitting positions: A comparison of persons with and without cerebral palsy. American Journal of Occupational Therapy, 45, 123–129.

13.

Menkes

J. H.

(1991). Perinatal asphyxia and trauma. In Menkes

J.H.

(Ed.), Textbook of child neurology (4th ed., pp. 284–326). Malvern, PA: Lea and Febiger.

14.

Ottenbacher

K. J.

(1986). Evaluating clinical change: Strategies for occupational and physical therapists. Baltimore: Williams and Wilkins.

15.

Reid

D. T.

(1984). Aid to independence: Hand splint for cerebral palsied children. Canadian Journal of Occupational Therapy, 51, 37–39.

16.

Reid

D. T.

(1992). A survey of Canadian occupational therapists' use of hand splints for children with neuromuscular dysfunction. Canadian Journal of Occupational Therapy, 59, 16–27.

17.

Reid

D. T.

, & Sochaniwskyj

(1992). Influences of a hand positioning device on upper-extremity control of children with cerebral palsy. International Journal of Rehabilitation Research, 15, 15–29.

18.

Reid

D. T.

Sochaniwskyj

, & Milner

(1991). An investigation of postural sway in sitting of normal children and children with neurological disorders. Physical and Occupational Therapy in Pediatrics, 11, 19–35.