Abstract
Background The wrist extensors and flexors are profoundly affected in most children with hemiparetic cerebral palsy (CP) and are the major target of physical therapists' and occupational therapists' efforts to restore useful hand functions. A limitation of any therapeutic or exercise program can be the level of the child's engagement or adherence. The proposed approach capitalizes on the primary learning avenue for children: toy play.
Objective This study aimed to develop and evaluate the measurement accuracy of innovative, motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP.
Design Design objectives of the play controller included a cost-effective, home-based supplement to physical therapy, the ability to calibrate the controller so that play can be accomplished with any active range of motion, and the capability of logging play activity and wrist motion over week-long periods.
Methods Accuracy of the play controller in measuring wrist flexion-extension was evaluated in 6 children who were developing in a typical manner, using optical motion capture of the wrist and forearm as the gold standard.
Results The error of the play controller was estimated at approximately 5 degrees in both maximum wrist flexion and extension.
Limitations Measurements were taken during a laboratory session, with children without CP, and no toy or computer game was interfaced with the play controller. Therefore, the potential engagement of the proposed approach for therapy remains to be evaluated.
Conclusions This study presented the concept, development, and wrist tracking accuracy of an inexpensive approach to extremity therapy that may have a health benefit for children with hemiparesis, and potentially for patients of any age with a wide range of extremity neuromotor impairments.
Footnotes
Dr Crisco, Mr Schwartz, Dr Wilcox, and Dr Kerman provided concept/idea/project design and writing. All authors provided data collection. Dr Crisco, Mr Schwartz, and Dr Wilcox provided data analysis. Dr Crisco, Mr Schwartz, and Dr Kerman provided project management. Dr Crisco and Dr Kerman provided fund procurement, facilities/equipment, and institutional liaisons. Dr Kerman provided participants and administrative support. Mr Schwartz and Dr Kerman provided consultation (including review of manuscript before submission).
This study was approved by the Institutional Review Board of Rhode Island Hospital.
The research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number R21HD071582. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors are indebted to Richard Maddocks and his associates at Hasbro Inc, Pawtucket, Rhode Island, for their support.
Dr Crisco is an inventor on a patent describing a method for facilitating fitting of the play controller to a child's arm using a malleable inner structure. The patent is owned by his employer, Rhode Island Hospital, Providence, Rhode Island.
- Received August 4, 2014.
- Accepted January 2, 2015.
- © 2015 American Physical Therapy Association
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