Beani Elena, Menici Valentina, Ferrari Adriano, Cioni Giovanni, Sgandurra Giuseppina
Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.
Children Rehabilitation Unit, Azienda USL - IRCCS Reggio Emilia, Reggio Emilia, Italy.
Front Neurol. 2020 Feb 28;11:16. doi: 10.3389/fneur.2020.00016. eCollection 2020.
Unilateral Cerebral Palsy (UCP), the most frequent form of Cerebral Palsy, usually affects more the upper limb (UL) than the lower limb. Rehabilitation programs are addressed to improve manual abilities and UL use. In recent years, Information and Communication Technology (ICT) has been introduced in rehabilitation to increase treatment opportunities for patients, and also in home-based intervention. Moreover, the discovery of the Mirror Neuron System allowed to insert a new paradigm of treatment that is the Action Observation Training (AOT). The aim of the present study was to investigate the feasibility of a new rehabilitative home-based approach, called Tele-UPCAT (Tele-monitored UPper Limb Children Action Observation Training), based on the principles of AOT, in a group of Italian children and adolescents with UCP. This investigation was to provide information about the possibility of introducing ICT in telerehabilitation field. Twenty-nine children aged 11.73 ± 3.65 years (range 6.00-18.75) with a diagnosis of UCP participated in the study. They carried out 15 days of training based on the AOT paradigm with Tele-UPCAT system while wearing Actigraphs on both wrists. The feasibility of both training and study design and procedures was assessed through nine criteria taken from existent literature and from a questionnaire designed and realized for the purpose, based on standard items of usability and acceptability. All feasibility criteria were met: 80% of training sessions were completed in the planned time and no significant technical issues were found. From the questionnaire, total scores were all above 82.15%, while the four sections obtained the following scores: (i) customization of exercises 80.00%; (ii) acceptability at home, 77.50%; (iii) required effort 80.00%; and (iv) suitability of manual and software 95.00%. No differences were found for age and sex. Tele-UPCAT demonstrated to be feasible as a home-based AOT for children and adolescents with UCP. Trial registration NCT03094455.
单侧脑瘫（UCP）是脑瘫最常见的形式，通常对上肢（UL）的影响比对下肢更大。康复计划旨在提高手部能力和上肢的使用。近年来，信息通信技术（ICT）已被引入康复领域，以增加患者的治疗机会，同时也用于家庭干预。此外，镜像神经元系统的发现使得一种新的治疗范式——动作观察训练（AOT）得以应用。本研究的目的是调查一种基于AOT原则的新型家庭康复方法——远程UPCAT（远程监测上肢儿童动作观察训练）在一组意大利UCP儿童和青少年中的可行性。这项调查旨在提供有关在远程康复领域引入ICT可能性的信息。29名年龄在11.73±3.65岁（范围6.00 - 18.75岁）、诊断为UCP的儿童参与了该研究。他们使用远程UPCAT系统，基于AOT范式进行了15天的训练，同时在双腕佩戴活动记录仪。通过从现有文献以及为该目的设计并实现的一份基于可用性和可接受性标准项目的问卷中选取的九条标准，评估了训练以及研究设计和程序的可行性。所有可行性标准均得到满足：80%的训练课程在计划时间内完成，未发现重大技术问题。从问卷来看，总分均高于82.15%，而四个部分的得分如下：（i）练习定制80.00%；（ii）在家中的可接受性77.50%；（iii）所需努力80.00%；（iv）手册和软件的适用性95.00%。在年龄和性别方面未发现差异。远程UPCAT被证明作为一种针对UCP儿童和青少年的家庭AOT方法是可行的。试验注册号：NCT03094455。
