Saussez Geoffroy, Van Laethem Marie, Bleyenheuft Yannick
1 Motor Skill Learning and Intensive Neurorehabilitation lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
2 Faculty of Motor Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
J Child Neurol. 2018 Mar;33(4):260-268. doi: 10.1177/0883073817753291.
Recently, an intensive bimanual intervention using sensory enriched materials resulted in improved tactile function in children with unilateral spastic cerebral palsy (USCP), raising the question of whether the observed tactile function improvement was due to the sensory enriched environment or the bimanual intervention per se. The present study investigates whether a bimanual intensive intervention improves tactile function. Nineteen children with USCP received 90 hours of bimanual training without enriched environment. Primary outcomes: Manual Form Perception Test/MFPT, Grating Orientation Task/GOT. Children were assessed before, after the training, and at the 4-month follow-up. Significant improvements were observed in MFPT for the more affected hand ( P = .015). Larger stereognosis/MFPT improvements correlated with poorer baseline motor function. Intensive bimanual training alone was sufficient to improve stereognosis, though no improvement in GOT was observed. Present and previously published findings suggest that environmental tactile enrichment incorporated into a bimanual motor training may be needed to improve spatial discrimination/GOT in children with USCP.
最近,一项使用富含感官刺激材料的强化双手干预措施,使单侧痉挛性脑瘫(USCP)患儿的触觉功能得到改善,这引发了一个问题:观察到的触觉功能改善是由于富含感官刺激的环境,还是双手干预本身。本研究调查双手强化干预是否能改善触觉功能。19名USCP患儿接受了90小时无丰富环境的双手训练。主要指标:手工形状感知测试/MFPT、光栅方向任务/GOT。在训练前、训练后以及4个月随访时对患儿进行评估。观察到受影响更严重的手在MFPT上有显著改善(P = 0.015)。更大的立体感觉/MFPT改善与较差的基线运动功能相关。单独的强化双手训练足以改善立体感觉,尽管未观察到GOT有改善。目前和先前发表的研究结果表明,可能需要将环境触觉丰富纳入双手运动训练中,以改善USCP患儿的空间辨别/GOT。