Effect of touch screen tablet use on fine motor functions in children with hemiparetic cerebral palsy: A randomized controlled trial

Abstract

BACKGROUND:

Cerebral palsy is the most frequent condition affecting the central nervous system and causing large disability.

OBJECTIVE:

To determine the impact of touch screen tablet upon fine motor functions in children with hemiparesis.

METHOD:

This was a randomized controlled trial involving 60 children, ranging in age from 5 to 7 years old, randomized into two groups: intervention or control group (30 children per group). Both groups were given 12 consecutive weeks of designed fine motor tasks. Additionally, for thirty minutes, the intervention group was given a fine motor exercise program on a touch screen tablet. Upper limb function, finger dexterity and pinch strength were measured pre and post the recommended treatment program using the quality of upper extremity skill test (QUEST), Nine-Hole Peg Test and Jamar hydraulic pinch gauge, respectively.

RESULTS:

All outcome measures were equivalent between intervention groups at admission (P > 0.05). Significant improvements were found in all assessed variables within the two groups. Meanwhile, the intervention group had significantly higher improvements (P < 0.05) in finger dexterity, pinch strength, and upper limb function when compared with the control groups.

CONCLUSION:

Including a touch screen smart tablet application with a specially designed fine motor program is an effective method that helps children with U-CP perform more effectively with their fine motor skills.

Keywords

Cerebral palsy hemiplegia fine motor tasks touch screen tablet unilateral cerebral palsy

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References

Abd-Elmonem,

A. M.

, Ali,

H. A.

, Saadeldien,

S. S.

, El-nabie,

W. A. A.

(2023). Efficacy of plyometric exercises on upper extremity function, selective motor control and hand grip strength in children with unilateral cerebral palsy: A randomized controlled study. Physiotherapy Research International, e2061. https://doi.org/10.1002/pri.2061.

Bear-Lehman,

, Kafko,

, Mah,

, Mosquera,

, Reilly,

(2002). An exploratory look at hand strength and hand size among preschoolers. Journal of Hand Therapy, 15, 340–346.

Beschorner,

, Hutchison,

(2013). iPads as a literacy teaching tool in early childhood. Online Submission, 1(1), 16–24. https://dr.lib.iastate.edu/handle/20.500.12876/22876.

Bohannon,

R. W.

, Smith,

M. B.

(1987). Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy, 67(2), 206–207. https://doi.org/10.1093/ptj/67.2.206.

Burridge,

J. H.

, Hughes,

A. M.

(2010). Potential for new technologies in clinical practice. Current Opinion in Neurology, 23(6), 671–677. https://doi.org/10.1097/WCO.0b013e3283402af5.

Case-Smith,

, Exner,

C. E.

(2015). Hand function evaluation and intervention. In

Case-Smith , &

J. C.

O’Brien (Eds.),(,). Occupational therapy for children and adolescents (7th ed., pp. 220–257). St.Louis, MO: Mosby.

Common Sense Media. (2011). Zero to eight: Children’s media use in America. Retrieved from: http://www.commonsense.org/research.

Cooper,

L. Z.

(2005). Developmentally appropriate digital environments for young children. Library Trends, 54, 286–302.

Couse,

L. J.

, Chen,

D. W.

(2010). A tablet computer for young children? Exploring its viability for early childhood education. Journal of Research on Technology in Education, 43(1), 75–96. DOI: 10.1080/15391523.2010.10782562.

10.

Darrah,

J.D.

Clinical reasoning: Management of a child with cerebral palsy. (1997). Comparison of neurodevelopmental and dynamic systems approaches. Symposium-book of the American Physical Therapy Annual Conference. San Diego, CA: APTA, 25–29.

11.

Darwesh,

, Hafez,

, Aboeleneen,

, El-Kafy,

, El-Sodany,

, Mohamed,

(2017). Effect of Smart tablet Applications on Hand Function in Children with Bilateral Spastic. Jokull. 67.

12.

Eliasson,

A. C.

, Bonnier,

, Krumlinde-Sundholm,

(2003). Clinical experience of constraint induced movement therapy in adolescents with hemiplegic cerebral palsy–a day camp model’. Developmental medicine and child neurology, 45(5), 357–359. https://doi.org/10.1017/s0012162203210665.

13.

Elnaggar,

R.K.

, Diab,

R.H.

, Abonour,

A.A.

, Alsubaie,

S.F.

, Alrawaili,

S.M.

, Alghadier,

, Mohamed,

E.H.

, Abd-Elmonem,

A.M.

(2022). Paretic-Limb-Only Plyometric Training Outperforms Volume-Matched Double-Limb Training for Ameliorating Balance Capability and Gait Symmetry in Adolescents with Unilateral Cerebral Palsy: A Comparative Study. Children, 9, 1563. https://doi.org/10.3390/children9101563.

14.

El-Shamy,

S. M.

(2018). Efficacy of Armeo^® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children With Hemiplegic Cerebral Palsy. American Journal of Physical Medicine & Rehabilitation, 97(3), 164–169. https://doi.org/10.1097/PHM.0000000000000852.

15.

Flewitt,

, Messer,

, Kucirkova,

(2015). New directions for early literacy in a digital age: The iPad. Journal of Early Childhood Literacy, 15(3), 289–310. https://doi.org/10.1177/1468798414533560.

16.

Gal,

, Lamash,

, Bauminger-Zviely,

, Zancanaro,

, Weiss,

P. L.

(2016). Using Multitouch Collaboration Technology to Enhance Social Interaction of Children with High-Functioning Autism. Physical & Occupational Therapy in Pediatrics, 36(1), 46–58. https://doi.org/10.3109/01942638.2015.1040572.

17.

Gaul,

, Issartel,

(2016). Fine motor skill proficiency in typically developing children: On or off the maturation track? Human movement science, 46, 78–85. https://doi.org/10.1016/j.humov.2015.12.011.

18.

Henderson,

, Korner-Bitensky,

, Levin,

(2007). Virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Topics in Stroke Rehabilitation, 14(2), 52–61. https://doi.org/10.1310/tsr1402-52.

19.

Hourcade,

J.P.

, Bullock-Rest,

N.E.

, Hansen,

T.E.

(2012). Multitouch tablet applications and activities to enhance the social skills of children with autism spectrum disorders. Pers Ubiquit Comput, 16, 157–168. https://doi.org/10.1007/s00779-011-0383-3.

20.

Howcroft,

, Klejman,

, Fehlings,

, Wright,

, Zabjek,

, Andrysek,

, Biddiss,

(2012). Active video game play in children with cerebral palsy: potential for physical activity promotion and rehabilitation therapies. Archives of Physical Medicine and Rehabilitation, 93(8), 1448–1456. https://doi.org/10.1016/j.apmr.2012.02.033.

21.

Jarrasse,

, Kühne,

, Roach,

, Hussain,

, Balasubramanian,

, Burdet,

(2013). Analysis of grasping strategies and function in hemiparetic patients using an instrumented object. IEEE Int Conf Rehabil Robot, 6650379. doi: 10.1109/ICORR.2013.6650379.

22.

Jarrassé,

, Kühne,

, Roach,

, Hussain,

, Balasubramanian,

, Burdet,

, Roby-Brami,

(2013). Analysis of grasping strategies and function in hemiparetic patients using an instrumented object. IEEE International Conference on Rehabilitation Robotics: [proceedings], 2013, 6650379. https://doi.org/10.1109/ICORR.2013.6650379.

23.

Ketelaar,

, Vermeer,

, Hart,

, van Petegem-van Beek,

, Helders,

P. J.

(2001). Effects of a functional therapy program on motor abilities of children with cerebral palsy. Physical Therapy, 81(9), 1534–1545. https://doi.org/10.1093/ptj/81.9.1534.

24.

Kucirkova,

, Messer,

, Sheehy,

, Panadero,

C. F.

(2014). Children’s engagement with educational iPad apps: Insights from a Spanish Classroom. Computers & Education, 71, 175–184. https://doi.org/10.1016/j.compedu.2013.10.003.

25.

Lauricella,

A. R.

, Wartella,

, Rideout,

V. J.

(2015). Young children’s screen time: The complex role of parent and child factors. Journal of Applied Developmental Psychology, 36, 11–17. https://doi.org/10.1016/j.appdev.2014.12.001.

26.

Levanon

(2013). The advantages and disadvantages of using high technology in hand rehabilitation. Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists, 26(2), 179–183. https://doi.org/10.1016/j.jht.2013.02.002.

27.

Lin,

L. Y.

, Cherng,

R. J.

, Chen,

Y. J.

(2017). Effect of Touch Screen Tablet Use on Fine Motor Development of Young Children. Phys Occup Ther Pediatr 37(5):457–467. doi: 10.1080/01942638.2016.1255290. Epub 2017 Jan 10. PMID: 28071977.

28.

Mahmoud,

A. M.

, Al-Tohamy,

A. M.

, Abd-Elmonem,

A. M.

(2021). Usage time of touch screens in relation to visual-motor integration and the quality of life in preschooler children. J Taibah Univ Med Sc 16(6):819e825. https://doi.org/10.1016/j.jtumed.2021.06.003.

29.

Mangen,

, Velay,

J. L.

(2010). Digitizing literacy: Reflections on the haptics of writing. In

M. H.

Zadeh (Ed.), Advances in haptics (pp. 385–401). Rijeka, Croatia InTech. DOI10.5772/8710.

30.

Mariblanca,

M. R.

, de la Cuerda,

R. C.

(2021). Mobile applications in children with cerebral palsy. Neurologia (English Edition), 36(2), 135–148.

31.

McManis,

L. D.

, Gunnewig,

S. B.

(2012). Finding the education in educational technology with early learners. Young Children, 67, 14–24.

32.

Naik,

S.K.

, Patten,

, Lodha,

, Coombes,

S.A.

, Cauraugh,

J.H.

(2011). Force control deficits in chronic stroke: grip formation and release phases. Exp Brain Res, 211(1), 1–15. 10.1007/s00221-011-2637-8.

33.

Neumann,

M. M.

, Neumann,

D. L.

(2014). Touch screen tablets and emergent literacy. Early Childhood Education Journal, 42(4), 231–239. DOI: 10.1007/s10643-013-0608-3.

34.

Nudo,

R. J.

(2007). Post-infarct cortical plasticity and behavioral recovery. Stroke, 38(2), 840–845.

35.

Palisano,

, Rosenbaum,

, Walter,

, Russell,

, Wood,

, Galuppi,

(1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine and Child Neurology, 39(4), 214–223. https://doi.org/10.1111/j.1469-8749.1997.tb07414.x.

36.

Poole,

J. L.

, Burtner,

P. A.

, Torres,

T. A.

, McMullen,

C. K.

, Markham,

, Marcum,

M. L.

, Anderson,

J. B.

, Qualls,

(2005). Measuring dexterity in children using the Nine-hole Peg Test. Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists, 18(3), 348–351. https://doi.org/10.1197/j.jht.2005.04.003.

37.

Rahmani,

, Boren,

S. A.

Videogames and health improvement: a literature review of randomized controlled trials. Games for Health Journal 1(5), 331–341. DOI: 10.1089/g4h.2012.0031.

38.

Rand

, Schejter-Margalit

, Dudkiewicz

, Kizony

, Zeilig

(2013). The use of the iPad for poststroke hand rehabilitation; a pilot study. Virtual rehabilitation (ICVR). Philadelphia, PA, USA: Proceeding at 10^th International Conference on Virtual Rehabilitation, p. 109–113. doi: 10.1109/ICVR.2013.6662068.

39.

Rand,

, Givon,

, Weingarden,

, Nota,

, Zeilig,

(2014). Eliciting upper extremity purposeful movements using video games: a comparison with traditional therapy for stroke rehabilitation. Neurorehabilitation and Neural Repair, 28(8), 733–739. https://doi.org/10.1177/1545968314521008.

40.

Roskos,

, Burstein,

, You,

B. K.

, Brueck,

, O’Brien,

(2011). A formative study of an E-book instructional model in early literacy. Creative Education, 2, 10–17.

41.

Saposnik

, Teasell

, Mamdani

, Hall,

, McIlroy,

, Cheung,

, et al. (2010). Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle. Stroke, 41, 1477–1484. org/10.1161/STROKEAHA.110.584979.

42.

Tahnk,

(2011). Digital milestones: Raising a tech-savvy kid.Parenting.com, November, (pp. 78–84).

43.

Thorley,

, Lannin,

, Cusick,

, Novak,

, Boyd,

(2012). Construct validity of the Quality of Upper Extremity Skills Test for children with cerebral palsy. Developmental Medicine and Child Neurology, 54(11), 1037–1043. org/10.1111/j.1469-8749.2012.04368.

44.

Whitall,

, McCombe Waller,

, Silver,

K. H.

, Macko,

R. F.

(2000). Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke, 31(10), 2390–2395. https://doi.org/10.1161/01.str.31.10.2390.

45.

You,

S. H.

, Jang,

S. H.

, Kim,

Y. H.

, Kwon,

Y. H.

, Barrow,

, Hallett,

(2005). Cortical reorganization induced by virtual reality therapy in a child with hemiparetic cerebral palsy. Developmental Medicine and Child Neurology, 47(9), 628–635.