The Role of Play-Based Therapy in Managing Motor Skills in Children with Cerebral Palsy (CP): A Systematic Review

Children with cerebral palsy have a main obstacle which is weakness in physical abilities, related to obstacles in muscles and joints either in the hands, feet or other parts of the body. This study aims to explore the effectiveness of clay-based intervention by applying a task analysis approach in improving fine motor skills in cerebral palsy children. Cerebral Palsy (CP) children experience movement disorders caused by impaired brain nerve function, Progressive Dystrophy. Children with disability can be classified into 2 types, namely, orthopedically handicapped children, which is defined as people with disability who experience movement barriers caused by certain deficiencies in muscles, bones, body, and joints. This research is a descriptive quantitative study that uses a Single Subject Research approach. It is a type of research that seeks to change the behavior of individuals or small groups and to document those changes. This research is different from experimental research where the researcher takes a sample and establishes the existence of a control group and behavior group. In Single Subject Research, the subject will serve as both the control group and the behavior group. The research design used in this article is the ABAB research design. ABAB research design is a type of SSR research that involves a baseline phase (A), an intervention phase (B), a second baseline phase (A2), and a second intervention phase (B2). The purpose of using this research design is to demonstrate the functional relationship between the intervention and the subject's behavior. The results showed that clay-based intervention with a task analysis approach was effective in improving fine motor skills in children with cerebral palsy. This study makes an important contribution to the field of special education by offering an innovative and effective intervention approach to improve fine motor skills in children with special needs.

One activity that can improve children's fine motor skills is cutting. The scissor activity aims to train eye coordination and hand muscles as well as concentration. Cutting can be a child's initial preparation stage for writing, especially when holding a pencil. The cutting activity is one of the stimuli that can be developed by educators in developing children's motor skills, especially children's fine motor skills. Children will be able to coordinate their eye senses and hand activities through cutting activities. The aim of this research is to determine the significant influence of paper cutting activities on the fine motor skills of group A at GKPI Tarutung City Kindergarten. The method used in this research is a quantitative descriptive research method. The population is all group A children in the GKPI Tarutung City Kindergarten, totaling 20 people. The improvement in children's fine motor skills can be seen from the children's accuracy in the indicators for variables paper on fine motor skills of group A children at GKPI Tarutung City Kindergarten = 36.5%. Thus, Ha, that is, there is a significant influence of paper cutting activities on the fine motor skills of group A at GKPI Tarutung City Kindergarten, is accepted and H0 is rejected.

This study was designed to examine the effects of intensive traditional physical therapy treatment methods combined with partial body weight treadmill training (PBWTT) on motor and ambulatory skills of children with cerebral palsy. Five children (2.3 to 9.7 years) with cerebral palsy participated in a therapy program for four weeks, three to four sessions per week, for two hours per session. Outcomes were measured using the Gross Motor Function Measure, Pediatric Evaluation of Disability Inventory, pedographs, and the Timed 10-Meter Walk Test. Wilcoxon paired-sample tests and percent changes showed a significant (p < 0.05) decrease in mean step length differences. Results indicate improvements in motor and ambulatory skills of individual children indicating positive measurable outcomes of intensive physical therapy with partial body weight treadmill training. An intensive episode of physical therapy of reasonable frequency and duration that includes partial body weight treadmill training may be effective in improving motor skills of children with spastic CP.

Purpose: To determine childhood predictors of participation in domestic life and interpersonal relationships of young adults with cerebral palsy (CP).Materials and methods: This 13-year follow-up of an existing cohort (baseline age 9–13 years) included 67 young adults with CP (age 21–27 years). The Vineland adaptive behavior scales (VABS) and Life Habits questionnaire were used to assess attendance and difficulty in participation in domestic life and interpersonal relationships. Baseline factors were categorised according to the international classification of functioning, disability, and health. Stepwise multiple linear regression analyses determined significant predictors (p < 0.05).Results: Lower manual ability, intellectual disability (ID), epilepsy and lower motor capacity predicted decreased future participation in domestic life, and/or interpersonal relationships (explained variance R2 = 67–87%), whereas no association was found with environmental and personal factors. Extending models with baseline fine motor skills, communication, and interpersonal relationships increased R2 to 79–90%.Conclusions: Childhood factors account for 79–90% of the variation in young adult participation in domestic life and interpersonal relationships of individuals with CP. Children with limited motor capacity, low manual ability, ID, or epilepsy are at risk for restrictions in participation in young adulthood. Addressing fine motor, communication, and social skills in paediatric rehabilitation might promote young adult participation.Implications for rehabilitationChildhood risk factors for limited participation in domestic life and interpersonal relationships as a young adult with CP are ID, epilepsy, low manual ability, low motor capacity, and low activity & participation levels.In line with current practice, this study confirms the importance of addressing gross and fine motor skills in children with CP for their future participation in domestic life.In addition, results suggest that addressing communication and social skills during paediatric rehabilitation may optimise future participation in interpersonal relationships.

Abstract. This study aims to find out: (1) The difference in the influence of the water game model and the dingklik relay game on the improvement of gross motor skills in deaf children. (2) The difference in the effect between high and low independence on the improvement of gross motor skills in deaf children. (3) The interaction between the water game model and the dingklik relay game was reviewed from the aspect of independence to improve gross motor skills in deaf children. This type of research is an experiment using a 2 x 2 factorial design. The population in this study is 38 deaf children of SLB N Mesuji Lampung. The sample in this study amounted to 20 deaf children who were taken using the purposive sampling technique, then ordinal pairing was carried out to divide each group. The instrument used was to measure independence using the questionnaire method, while gross motor used (1) a test of walking on a straight line of 5 meters, (2) a test of running avoiding five obstacles as far as 15 meters, (3) a test of standing on one foot for 10 seconds, (4) a test of jumping from a 15 cm high block, (5) a test of jumping from a 15 cm high beam. The data analysis technique used is ANOVA two-way. The results showed that: (1) There was a difference in the influence of the water game model and the dingklik relay game on the improvement of gross motor skills in deaf children, with a value of F 8.667 and a significance value of p 0.010 &lt; 0.05. The water competition group was higher (good) compared to the dingklik relay game group with an average posttest difference of 1.3. (2) There is a difference in the influence between high and low independence on the improvement of gross motor ability in deaf children, it is proven that the F value is 22.615 and the significance value p is 0.000 &lt; 0.05. Children who have high independence are higher (good) compared to children who have low independence, with an average posttest difference of 2.1. (3) There was an interaction between the water game model and the dingklik relay game from the aspect of independence (high and low) on the improvement of gross motor skills in deaf children, with a value of F 70.205 and a significance value of p 0.000 &lt; 0.05.

This research is motivated by the low development of children's motor skills in PAUD Mekar Sari, this is caused by many factors, one of which is thought to be because of uninteresting media, thus making children bored in learning. The selection of learning media is one of the ways to achieve learning objectives, especially in improving children's motor skills, especially fine motor skills. This study aims to determine the ability to increase the effectiveness of the use of eggshell collage media in improving the fine motor skills of children aged 5-6 years at PAUD Mekar Sari. This type of research is quantitative with a quasi-experimental method with pretest and posttest designs. The population of this study is 15 children aged 5-6 years at PAUD Mekar Sari for the academic year 2021-2022, with a research sample of 15 children taken by purposive sampling technique. Data analysis used paired sample t-test. The results showed that before being given the action (pretest) the children's fine motor skills were categorized as starting to develop, after being given the action (posttest) the children's fine motor skills were categorized as developing and there was an influence of eggshell collage media on fine motor skills in children. Sig 0.000 &lt; 0.05, it is recommended for parents and teachers to use eggshell collage media in improving children's fine motor skills.Keywords: Eggshell Collage Media, Fine Motor Ability

Enhancing motor skills is crucial for the functional development of children with cerebral palsy. Virtual reality has emerged as a promising technology for rehabilitating these children. The objective of this study was to systematically evaluate the effects of virtual reality motor games on the gross and fine motor skills of children with cerebral palsy. A comprehensive search was conducted in databases including PubMed, ProQuest, EBSCOhost, Web of Science, and Wanfang Data, covering publications from their inception to June 1, 2024, to identify randomized controlled trials (RCTs) investigating the effects of virtual reality motor games on the gross and fine motor skills of children with cerebral palsy. The quality of the included studies was assessed using the PEDro scale, and data were analyzed with RevMan software (version 5.4). Nineteen studies involving 850 children with cerebral palsy were included. The results indicated that virtual reality motor games significantly improved gross motor skills [mean difference (MD) 1.67, 95% confidence interval (CI): 0.75-2.56; P < 0.001] and fine motor skills [standardized mean difference (SMD) 0.73, 95% CI: 0.30-1.16; P = 0.00008] in children with cerebral palsy. Virtual reality motor games have the potential to significantly enhance both gross and fine motor skills in children with cerebral palsy. https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42024558713].

Children with cerebral palsy (CP) typically exhibit lower fine motor skills compared to their typically developing peers. Various interventions, including constructive LEGO play, have been explored to support fine motor skill development. This study examines the effectiveness of constructive LEGO play in enhancing fine motor skills in children with CP at SDLB Putra Jaya Malang. A Single-Subject Design (SSD) with an A-B-A format was employed. Data were collected through structured observations and assessments of fine motor skills during baseline, intervention, and post-intervention phases. Findings indicate a notable improvement in fine motor skills from the first baseline (A1) to the intervention phase (B), with sustained progress in the second baseline (A2) after the intervention was withdrawn. This suggests that constructive LEGO play positively influences fine motor skill development in children with CP. The study highlights the potential of LEGO-based activities as an engaging and effective tool for improving fine motor coordination in children with CP. The observed progress reinforces the need for structured and repetitive fine motor activities in special education settings. Constructive LEGO play proves to be a beneficial intervention for enhancing fine motor skills in children with CP. Its integration into therapy and special education programs could provide long-term benefits. Further research is recommended to explore its scalability and long-term impact.

This study investigated how accurately parents and day-care teachers perceive young children's fine motor, gross motor, and language skills. Subjects were 30 preschool-age children, 30 mothers or primary caregivers, 16 fathers, and 30 day-care center teachers. Children's skills were measured by their performance on 21 items near their age levels on the Denver Developmental Screening Test. Parents' and teachers' perceptions, measured by their judgments as to whether they thought the child was capable of performing the 21 skills, were scored as underestimates, hits, or overestimates. Paired t tests comparing mothers', fathers', and teachers' responses yielded no differences between groups except mothers overestimated children's gross motor skills and teachers underestimated children's fine motor skills more than fathers. Correlations confirmed the lack of differences.

The purpose is to validate and discuss the possibilities to use the Motorisk Utveckling som Grund för Inlärning (Motor skills Development as Basis for Learning, MUGI) observation checklist as a measurement instrument for gross motor skills and to introduce the MUGI model for motor training as an alternative to improve children's motor skills in practice. Motor skills observations were carried out on all pupils in the first three school years at a state-funded primary school in Sweden (n = 251). Pupils in an intervention group (n = 152) had one lesson of physical activity and motor training every school day and also, when needed, an extra motor training lesson per week. The MUGI observation checklist, which includes 16 items that measure static and dynamic balance, bilateral coordination, and eye-hand coordination, was validated and tested for reliability. After one year of intervention, the pupils in the intervention group had significantly better (p < 0.05) motor skills than pupils in the control group. Results of factor analysis, reliability tests, and evaluator agreement show that the MUGI observation checklist fulfills requirements at an acceptable level of validity and reliability. The MUGI model was found to function well in practice for improving children's motor skills. The MUGI observation checklist could be an alternative to current measurement instruments in studies of children's gross motor skills, and also function as planning documentation for individual intervention programs. The MUGI model could be used to improve children's motor skills in practice.

본 연구의 목적은 뇌성마비의 아동의 운동기술과 처리기술에 영향을 미치는 감각처리 요인을 증명하여 뇌성마비 아동을 위한 재활 치료 중재 시 임상적 고려 사항을 파악하고자 하였다. 서울시 소재 J 소아발달센터와 N 재활병원 병원에 내원 중인 뇌성마비 아동 36명을 대상으로 운동 및 처리기술 평가와 단축형 감각 프로파일 검사를 실시하였다. Pearson의 상관계수를 이용하여 뇌성마비 아동의 운동기술과 처리기술 및 감각처리능력과의 상관관계를 검증하였고, 위계적 다중회귀분석을 통해 운동기술과 처리기술에 영향을 주는 주된 감각처리 요인들을 검증하였다. 연구 결과, 운동기술은 감각처리 항목 중 청각여과하기, 활력부족/허약, 시/청각 민감성 항목과 유의미한 상관성을 나타내었다. 처리기술은 촉각민감성, 맛/냄새 민감성 항목과 유의미한 상관성을 나타내었다. 위계적 다중회귀 모형에서 운동기술에 영향을 주는 주요 요인은 움직임 민감성, 청각여과하기, 활력부족/허약 항목이었다. 처리기술에 영향을 주는 요인은 본 연구의 모형에서는 확증되지 않았다. 이번 연구는 뇌성마비 아동을 대상으로 일상생활 활동시 운동기술과 처리기술에 영향을 주는 감각처리 요인들의 관련성과 주요 요인을 검증하여 재활치료를 위한 기초자료를 제공하는데 그 의의가 있다. 추후 연구에서는 더 많은 뇌성마비 아동의 집단을 대상으로 연구가 진행되어 본 연구에서 확인되지 못한 처리기술에 영향을 주는 감각처리 요인들을 검증해볼 필요가 있다. This study was conducted to identify sensory processing factors that affect motor and process skills of children with cerebral palsy. A total of 36 children with cerebral palsy who attended at the J pediatric development center and the N rehabilitation hospital in Seoul participated. Pearson's correlation coefficients were used to test the relationship between motor skills, process skills and sensory processing abilities of children. Moreover, hierarchical multiple regression was used to identify the sensory processing factors influencing motor and process skills. Motor skills of children with cerebral palsy were correlated with auditory filtering, low energy/weakness, and visual/auditory sensitivity of sensory processing items, whereas process skills were correlated with tactile sensitivity and taste/smell sensitivity. The hierarchical regression model for motor skills revealed movement sensitivity, auditory filtering, and low energy/weakness as significant factors influencing sensory processing items. However, no factors were shown to influence process skills. The results of this study will be useful as a basic resource for rehabilitation of children with cerebral palsy. However, further studies evaluating a larger population should be conducted to verify the results presented herein.

Introduction: Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates motor performance and learning. Previous studies have shown that tDCS over the primary motor cortex (M1) can facilitate consolidation of various motor skills in healthy subjects; but the effect of tDCS on motor skills improvement in autism spectrum disorders (ASD) remains unknown. The aim of the current study was to examine the effects of anodal tDCS and selective motor training on fine motor skills in 6-14-year-old children with ASD. Materials and Methods: This was an experimental research with a pretest–posttest design. A total of eighteen children with ASD (age range 6-14 years) were selected according to available sampling and inclusion criteria and then were randomly divided to experimental and control group. Nine subjects received 1.5 mA anodal tDCS over the left M1 for 20 min before the training session and practiced motor training after tDCS to improve fine motor skills. The remaining 9 subjects underwent identical training sessions, except that tDCS was artificially applied for them (sham group). Fine motor skills were assessed at baseline (pre-intervention) and after 10 sessions (post-intervention). Results: Anodal tDCS and fine motor skill training have significant effects on fine motor skills in children with ASD (P < 0.05). Conclusion: Our findings suggest that tDCS may be considered as a useful adjunct to fine motor skill training for children with ASD, although studies in a larger group of children with varying levels of autistic traits and different stimulation polarity are needed to evaluate the functional use of non-invasive brain stimulation.

The fine motor skills of children with intellectual disabilities vary and are influenced by several factors including parents’ contributions. This study was set to determine the children's motor skills and the role of parents in the fine motor skills of children with intellectual disabilities. The subjects of this study were 47 children with intellectual disabilities aged 7-8 years and their parents. Fine motor skills are obtained through assessment using fine motor skills instruments of children with intellectual disabilities. Meanwhile, the data on the role of parents on children's fine motor skills were gathered through a questionnaire. The results showed that the fine motor skills of this group mostly developed as expected. The contribution of parents to the children's motor skills is shown by providing early stimulation and early intervention through involving children in various activities in daily life.

Poor motor skills in children with developmental coordination disorder (DCD) are associated with childcare stress. This study aimed to assess whether improving the motor skills of children with DCD could reduce parenting stress. The participants were five boys aged 7-10 years with probable DCD and their parents. The intervention comprised 1 hour per week of motor skills training for nine weeks. We measured improvements in the children's motor skills and reductions in parenting stress before and after the intervention. All five children showed improvements in motor skills. Parenting stress was reduced in two parents, whereas it worsened in three parents. Improving motor skills in children with probable DCD may not necessarily reduce parenting stress.

PP12.6 – 2933: Objective evaluation of functional outcomes using the assessment of motor and process skills (AMPS) following deep brain stimulation (DBS). Can we improve what really matters to children and young people?