Abstract
The movements of the affected upper limb in infantile hemiplegia are slower and clumsy. This leads to a decrease in the use of the affected hand. The visual effect obtained using the mirror box and the observation of actions in another individual can activate the same structural neuronal cells responsible for the execution of these actions. This research will study the affected upper limb functionality in hemiplegia infantile from 6 to 12 years old after the application of two intervention protocols: observation action therapy and mirror therapy combined with observation action therapy. Children with a diagnose of congenital infantile hemiplegia will be recruited to participate in a randomized controlled trial with two intervention protocols during four weeks (1 h per/day; 5 sessions per/week): Mirror Therapy Action Observation (MTAO) or Action Observation Therapy (AOT). The study variables will be: spontaneous use, measured with the Assisting Hand Assessment (AHA); manual ability measured with the Jebsen Taylor Hand Function Test (JTHFT); surface electromyography of the flexors and extensors muscles of the wrist and grasp strength through a grip dynamometer. Four assessments will be performed: At baseline situation, at the end of treatment, 3 and 6 months after treatment (follow-up assessments). This study will study the effects of these therapies on the use of the affected upper limb in children with hemiplegia.
Highlights
Infantile hemiplegia is a subtype of infantile cerebral palsy (CP), characterized by the involvement of one of the halves of the body due to a brain injury
Movements in the affected upper limb are slower and clumsy and are accompanied by mirror movements (MM) which are involuntary symmetrical movements observed in the contralateral upper limb to the voluntary upper limb movements
The sample size calculation has been based on the projected effect of the treatment on the main outcome measure, the Assisting Hand Assessment (AHA)
Summary
Infantile hemiplegia is a subtype of infantile cerebral palsy (CP), characterized by the involvement of one of the halves of the body due to a brain injury. The affected hand has a deficit in proprioception and tactile perception, which hinders fine motor skills, generally those of the fingers and the strength exerted by them [2]. Movements in the affected upper limb are slower and clumsy and are accompanied by mirror movements (MM) which are involuntary symmetrical movements observed in the contralateral upper limb to the voluntary upper limb movements. These movements are temporally observed in the development of the healthy child and disappear. Children with hemiplegia have deficits in the selective control of the affected fingers and a diminished use of them. The use of the affected hand is reduced, which is commonly known as “developmental neglect”, affecting activities of daily living [7,8,9]
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