brain lesion cerebral palsy
Conditions
Interventions
After inclusion the TOAST-CP treatment will start based on the three selected
goals and an analysis of the task performance will be made of each of these
three goals. The results of the task analysi
Sponsors
Adelante Zorggroep
Eligibility
Age
2 Years to 17 Years
Inclusion criteria
Inclusion criteria: * Age 8-18 years * Spastic Cerebral Palsy (according to the Surveillance of Cerebral Palsy in Europe (SCPE) * Gross Motor Function Classification System (GMFCS) I-IV * Manual Ability Classification System (MACS) I-III * Hand function impairment Zancolli grade I- IIB * Children have to be able to comprehend tasks and perform the measurements and training, judged by the rehabilitation physician of the project team. The clinical data of the children regarding cognitive deficits and learning difficulties are available for this study. * Able to communicate in Dutch or English. * * Realistic problems performing manual activities. * Reduced upper limb strength. * Strength difference between the left and right arm of at least 20%. * Children and their parents indicate the necessity for improvement of the children*s manual abilities
Exclusion criteria
Exclusion criteria: * Severe impairment of hand function: no active hand function (Zancolli III) * Upper limb hand surgery within the last six months * Botulinum toxin-A injection of the upper limb within the last three months * Have undertaken an upper limb specific strength training program within the last three months Botulinum Toxin-A or Surgery is necessary during the trial period.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Activity Level At the activity level, measures of hand skills, bimanual performance and manual ability will be used. Primary outcome measure: The Assisting Hand Assessment (AHA) measures the typical performance of a child*s assisting hand in a range of bimanual activities. The AHA measures ability and performance of use of the affected hand in bimanual play by standardized video observation. | — |
Secondary
| Measure | Time frame |
|---|---|
| Activity Level At the activity level, measures of hand skills, bimanual performance and manual ability will be used. Primary outcome measure: The Assisting Hand Assessment (AHA) measures the typical performance of a child*s assisting hand in a range of bimanual activities. The AHA measures ability and performance of use of the affected hand in bimanual play by standardized video observation. Secondary outcome measures: Activity Level 1. The Observation and Scoring of Arm hand Skills (OSAS) is a video-based observation system to observe the spontaneous use of the affected limb in standardized bimanual fine and gross motor tasks (threading beads task, construction tasks small and large, making a sandwich tasks and stacking cylinder tasks). 2. The ABILHAND-Kids is a 21-item questionnaire based on existing scales and expert advice. The ABILHAND-kids is a functional scale specifically developed to measure manual ability in children with CP (up to 12 years). 3. The Jebsen Taylor test will be used to score the velocity of the use of the affected hand in functional standardized tasks. Participation Level 1. The domain frequency of use of the Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities for Children (PAC) will be used to document this outcome. The CAPE/PAC has been developed to determine the outcome on participation once per three months. 2. Enjoyment of the child during the training will be assessed using the Youth Rating Scale of the Behavioral and Emotional Rating Scale Second Edition (BERS-2). Body function/Body structure At the body function/ structure level (ICF-CY), measurement of muscle strength, spasticity and active and passive range of movement will be performed. 1. Measurement of strength will include both dynamic and isometric components of strength and the next tests will be performed: a. Grip and pinch strength will be measured using the E-link from Biometrics (isometric strength) | — |
Countries
Netherlands
Outcome results
None listed