Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA.
Phys Occup Ther Pediatr. 2024;44(6):844-864. doi: 10.1080/01942638.2024.2360462. Epub 2024 Jun 11.
Our study investigates the feasibility and utility of implementing a dual joystick-operated ride-on-toy navigation training (RNT) program within a 3-week intensive camp based on principles of modified constraint-induced movement therapy and bimanual training, to improve upper extremity (UE) function in children with unilateral cerebral palsy (UCP).
We employed a single-group pretest posttest, mixed methods study design. Eleven 4-to-10-year-old children with UCP received RNT as part of camp activities. Sessions required children to use both arms together for navigation and completing gross and fine motor UE challenges. We collected exit questionnaires from children, caregivers, and clinicians to assess the feasibility, acceptance, enjoyment, and perceived efficacy of RNT. Videos of training sessions were coded using Datavyu behavioral coding software to assess children's facial expressions and affective states, indicative of their level of engagement during intervention sessions.
We found high levels of child engagement during RNT sessions based on video data and stakeholder feedback. The RNT program was smoothly integrated into the camp. Stakeholders acknowledged the highly motivating nature of RNT. When combined with other camp activities, the program led to stakeholder-reported improvements in bimanual skills and spontaneous daily use of the affected UE.
Our pilot study provides promising evidence for using joystick-operated ride-on toys as engaging therapy adjuncts. Our findings call for future studies to systematically assess the efficacy of these devices in improving UE function among children with UCP.
本研究旨在探讨在基于改良强制性诱导运动疗法和双手训练原则的为期 3 周的强化夏令营中，实施双操纵杆骑行玩具导航训练（RNT）计划的可行性和实用性，以改善单侧脑瘫（UCP）儿童的上肢（UE）功能。
我们采用单组前后测混合方法设计。11 名 4 至 10 岁的 UCP 儿童在营地活动中接受 RNT。课程要求儿童同时使用双臂进行导航，并完成粗大和精细运动 UE 挑战。我们从儿童、照顾者和临床医生处收集了退出问卷，以评估 RNT 的可行性、接受度、享受度和感知效果。使用 Datavyu 行为编码软件对培训课程的视频进行编码，以评估儿童在干预过程中的面部表情和情感状态，这些表情和状态表明他们的参与程度。
根据视频数据和利益相关者的反馈，我们发现 RNT 课程中儿童的参与度很高。RNT 计划顺利融入了营地。利益相关者承认 RNT 具有高度的激励性。当与其他营地活动结合使用时，该计划导致利益相关者报告称双上肢技能和受影响 UE 的日常自发性使用有所改善。
我们的初步研究为使用操纵杆骑行玩具作为有趣的治疗辅助手段提供了有希望的证据。我们的研究结果呼吁未来的研究系统评估这些设备在改善 UCP 儿童 UE 功能方面的效果。
