Sudha Srinivasan, PT, PhD, is Assistant Professor, Physical Therapy Program, Department of Kinesiology; Affiliate, Institute for Collaboration on Health, Intervention, and Policy; and Affiliate, The Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs;
Nidhi Amonkar, PT, is Graduate Student, Physical Therapy Program, Department of Kinesiology; Affiliate, Institute for Collaboration on Health, Intervention, and Policy; and Affiliate, The Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs.
Am J Occup Ther. 2024 Jul 1;78(4). doi: 10.5014/ajot.2024.050589.
Children with hemiplegic cerebral palsy (HCP) require intensive task-oriented training to make meaningful gains in affected upper extremity (UE) motor function.
To evaluate the acceptability and utility of single joystick-operated ride-on toy (ROT) navigation training incorporated into a modified constraint-induced movement therapy (CIMT) camp for children with HCP.
Single group pretest-posttest design.
Three-wk structured CIMT camp.
Eleven children with HCP between ages 3 and 14 yr.
Children received group-based CIMT for 6 hr/day, 5 days/wk, for 3 wk. As part of camp activities, children also received ROT navigation training for 20 to 30 min/day, 5 days/wk, for 3 wk.
We assessed children's acceptance of ROT training by monitoring adherence and evaluating child engagement (affect and attention) during training sessions. The effects of ROT training combined with other camp activities on children's affected UE motor function were also assessed with the standardized Quality of Upper Extremity Skills Test (QUEST) and training-specific measures of ROT maneuvering accuracy.
Children demonstrated high levels of training adherence, positive affect, and task-appropriate attention across weeks. Positive engagement during ROT sessions was correlated with independent navigation. We also found medium- to large-sized improvements in QUEST scores and toy-maneuvering capabilities after the combined program.
Our pilot data support the use of joystick-operated ROTs as child-friendly therapy adjuncts that can be incorporated into intensive UE training programs to improve adherence and motivation in therapy programs, boost treatment dosing, and promote affected UE motor function in children with HCP. Plain-Language Summary: This pilot study offers promising evidence that supports the use of modified single joystick-operated ride-on toys (ROTs) for children with hemiplegic cerebral palsy (HCP). The study used ROTs as one of several interventions that were part of a constraint-induced movement therapy (CIMT) camp program for children with HCP. The ROTs boosted children's motivation, their engagement with and adherence to training, and their practice in using their affected upper extremity (UE) for goal-directed activities in their natural settings. ROTs are accessible, age-appropriate, and easy-to-use devices for both occupational therapy clinicians and families to encourage children to use their affected UEs by challenging their perceptual, motor-planning, problem-solving, and movement-control skills in an enjoyable and engaging way. ROTs can be used within and outside conventional rehabilitation settings.
患有偏瘫脑瘫（HCP）的儿童需要进行密集的任务导向训练，以在受影响的上肢（UE）运动功能上取得有意义的进步。
评估单操纵杆骑乘玩具（ROT）导航训练在修改后的强制性运动疗法（CIMT）营中对 HCP 儿童的可接受性和实用性。
单组预测试后测试设计。
为期 3 周的结构化 CIMT 营地。
11 名年龄在 3 至 14 岁之间的 HCP 儿童。
儿童每天接受 6 小时的团体 CIMT，每周 5 天。作为营地活动的一部分，儿童还接受每天 20 到 30 分钟的 ROT 导航训练，每周 5 天，为期 3 周。
我们通过监测训练期间的依从性并评估儿童的参与度（影响和注意力）来评估 ROT 训练的接受程度。还使用标准化的上肢技能测试（QUEST）和特定于 ROT 操纵的准确性的训练措施评估 ROT 训练与其他营地活动相结合对儿童受影响的 UE 运动功能的影响。
在数周内，儿童表现出高水平的训练依从性、积极的情绪和任务适当的注意力。在 ROT 会议期间的积极参与与独立导航相关。在综合方案后，我们还发现 QUEST 分数和玩具操纵能力有中等至较大的改善。
我们的初步数据支持使用操纵杆操作的 ROT 作为对儿童友好的治疗辅助工具，可以将其纳入强化 UE 训练计划中，以提高治疗计划中的依从性和动力，增加治疗剂量，并促进 HCP 儿童受影响的 UE 运动功能。
这项初步研究提供了有希望的证据，支持对偏瘫脑瘫（HCP）儿童使用改良的单操纵杆骑乘玩具（ROT）。该研究将 ROT 用作 HCP 儿童强制性运动疗法（CIMT）营地计划中的多项干预措施之一。ROT 提高了儿童的动力、他们对训练的参与度和依从性，并提高了他们在自然环境中使用受影响的上肢（UE）进行目标导向活动的能力。ROT 对于职业治疗临床医生和家庭来说都是一种易于使用的设备，可以通过以有趣和吸引人的方式挑战他们的感知、运动规划、解决问题和运动控制技能，鼓励儿童使用他们受影响的 UE。ROT 可以在常规康复环境内外使用。
