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基于家庭的双手训练治疗单侧脑瘫儿童的过程评估(COAD 研究):一项混合方法研究。

Process Evaluation of Home-based Bimanual Training in Children with Unilateral Cerebral Palsy (The COAD-study): A Mixed Methods Study.

机构信息

Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht, The Netherlands.

Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.

出版信息

Dev Neurorehabil. 2022 May;25(4):246-262. doi: 10.1080/17518423.2021.2011459. Epub 2021 Dec 26.

Abstract

PURPOSE

To evaluate the processes and factors that influenced implementation and impact of a home-based bimanual training program in children with unilateral cerebral palsy aged 2 through 7 years.

METHODS

The program encompassed bimanual task-specific training (3.5 hours/week for 12 weeks) adopting either implicit or explicit motor learning. A therapist and remedial educationalist coached parents. This mixed methods study included course attendance monitoring, questionnaires, registration form, video analysis, interviews, focus group discussion, and drop-out monitoring.

RESULTS

Fourteen families participated. The program was not fully implemented as intended. Parents positively experienced the training and were well able to provide it. The program was demanding for the children and time-consuming for parents. Several components positively contributed to the program: task-analysis, instructional videos, and coaching by a therapist and remedial educationalist. Several modifications to the program were proposed.

CONCLUSION

Home-based bimanual training forms a demanding but promising therapeutic approach with potential for optimization.

摘要

目的

评估家庭为基础的双手训练计划在 2 至 7 岁单侧脑瘫儿童中的实施过程和影响因素。

方法

该计划包括双手特定任务的训练(每周 3.5 小时,共 12 周),采用内隐或外显的运动学习。一名治疗师和一名补救教育者指导家长。这项混合方法研究包括课程出勤监测、问卷调查、登记表、视频分析、访谈、焦点小组讨论和辍学监测。

结果

共有 14 个家庭参与。该计划没有完全按照预期实施。家长们对培训的体验是积极的,并且能够很好地提供培训。该计划对儿童来说要求很高,对家长来说也很耗时。该计划的几个组成部分有积极贡献:任务分析、教学视频以及治疗师和补救教育者的指导。对该计划提出了一些修改建议。

结论

家庭为基础的双手训练是一种具有挑战性但很有前途的治疗方法,具有优化的潜力。

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