Hung Ya-Ching, Ferre Claudio L, Gordon Andrew M
a Department of Family, Nutrition, and Exercise Sciences, Queens College , City University of New York , Flushing , New York , USA.
b Burke-Cornell Medical Research Institute , White Plains , New York , USA.
Phys Occup Ther Pediatr. 2018 Nov;38(4):370-381. doi: 10.1080/01942638.2017.1337663. Epub 2017 Jul 28.
To evaluate the effects of home-based intensive bimanual training for children with unilateral spastic cerebral palsy (USCP) on bimanual coordination using 3-D kinematic analyses.
Seven children with USCP (aged 29-54 months, MACS level: I-III) received 90 hours (2 hrs/day, 5days/week for 9 weeks) of Home Hand-Arm Bimanual Intensive Training (H-HABIT) provided by trained caregivers. A bimanual drawer-opening task was evaluated with eight infrared cameras using VICON workstation4.6 before and after training to assess improvements in bimanual coordination.
H-HABIT training significantly decreased the time between one hand opening the drawer and the other hand manipulating its contents (p < 0.05) and increased the percentage of time when both hands were moving simultaneously (p = 0.001), which are indicators of improved temporal bimanual coordination. In addition, participants demonstrated a 26% decrease in trunk displacement (p < 0.05), a 30% increase in upper arm joint excursion (p < 0.01), and a 25% increase in elbow extension (p < 0.05) for the affected side. All the improvements were maintained at 6-month posttest.
H-HABIT improved not only temporal, but also quality of movement during a bimanual task for seven children with USCP. Thus, H-HABIT could be an alternative or adjunctive treatment for children with USCP.
采用三维运动学分析评估针对单侧痉挛性脑瘫（USCP）儿童的家庭强化双手训练对双手协调性的影响。
7名USCP儿童（年龄29 - 54个月，MACS分级：I - III级）接受了由经过培训的护理人员提供的90小时（每天2小时，每周5天，共9周）的家庭手-臂双手强化训练（H - HABIT）。在训练前后，使用VICON工作站4.6通过8个红外摄像头对双手打开抽屉任务进行评估，以评估双手协调性的改善情况。
H - HABIT训练显著减少了一只手打开抽屉与另一只手操作抽屉内物品之间的时间间隔（p < 0.05），并增加了双手同时移动的时间百分比（p = 0.001），这些都是双手时间协调性改善的指标。此外，参与者患侧的躯干位移减少了26%（p < 0.05），上臂关节活动度增加了30%（p < 0.01），肘部伸展增加了25%（p < 0.05）。所有改善在测试后6个月时仍保持。
H - HABIT不仅改善了7名USCP儿童在双手任务中的时间协调性，还改善了运动质量。因此，H - HABIT可以作为USCP儿童的一种替代或辅助治疗方法。
