Abstract
Aims: The aim of the study is to investigate if the new method of auditory and visual biofeedback as Upper Limb Exercise may improve praxis skills alone without any traditional physical therapy treatment or not and within three successive months of treatment in children with hemiplegic cerebral palsy. Methods: A 6-year-old hemiplegic cerebral palsied child was treated with Upper-Limb Exerciser as one of augmented visual and auditory feedback devices. Sensory Integration and Praxis test was used to measure a child’s ability to integrate sensory input for perception, motor planning, and spatial actions in; Space Visualization, Figure-Ground Perception, Standing and Walking Balance, Design Copying, Postural Praxis, Bilateral Motor Coordination, Constructional Praxis, Postrotary Nystagmus, Motor Accuracy, Sequencing Praxis, Oral Praxis, Manual Form Perception, Kinesthesia, Finger Identification, Graphethesia, Localization of Tactile Stimuli, and Praxis on Verbal Command. Results: The results revealed improvement of the major standard score for each of the 17 subtests of Sensory Integration and Praxis Test when compared after three successive treatment. Conclusion: The using upper limb exerciser as one method of augmented visual and auditory feedback can be used as one of the physical and occupational therapy programs aiming to improve praxis skills in hemiplegic cerebral palsied children.
Highlights
This study was focused on the most common subtype of cerebral palsy (CP), spastic hemiplegia affecting more than 38% of cases of CP [1] [2], which occur as a result of unilateral lesions to the cerebral cortex or corticospinal pathways [3]
The results revealed improvement of the major standard score for each of the 17 subtests of Sensory Integration and Praxis Test when compared after three successive treatment
Dyspraxia is a disorder influencing the management of movements commonly used for daily activities and to accomplish expressive gestures, be they linked to the use of an object, transitive, or abstract and with a symbolic content, intransitive [6] [7]
Summary
This study was focused on the most common subtype of cerebral palsy (CP), spastic hemiplegia affecting more than 38% of cases of CP [1] [2], which occur as a result of unilateral lesions to the cerebral cortex or corticospinal pathways [3]. The available studies on CP children were designed to investigate the effect of auditory or visual augmented feedback on tracing line drawing task [26], upper limb performance and hand function [27] or treatment of equines gait [28]. The new method of augmented visual feedback training by using Upper Limb Exerciser to improve different types of praxis skills has not been investigated on hemiplegic CP patients. The main objective of this study is to investigate the effectiveness of visual and auditory augmented feedback by using Upper Limb Exerciser system alone without any traditional physical therapy treatment within three successive months of treatment in hemiplegic CP children with dyspraxia
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