Developing the Observatory Test of Capacity, Performance, and Developmental Disregard (OTCPDD) for Children with Cerebral Palsy

<div><p>Purpose</p><p>The purpose of this study was to develop a reliable and valid instrument, named the Observatory Test of Capacity, Performance, and Developmental Disregard (OTCPDD), for measuring the amount and quality of use of affected upper limb functions in the daily routines of children with CP.</p><p>Methods</p><p>Forty-eight participants (24 children with CP and 24 matched typically developing children) were recruited. The OTCPDD was administered twice (the spontaneous use condition first, followed by the forced use condition) on children with CP. Their parents were asked to complete the Pediatric Motor Activity Log-Revised (PMAL-R). The internal consistency, the intrarater and interrater reliabilities, and the convergent and discriminate validities were measured.</p><p>Results</p><p>The internal consistency (Cronbach’s alpha) and the intrarater and interrater reliabilities were higher than 0.9 for all of the OTCPDD scores. The convergent validity was confirmed by significant correlations between the OTCPDD and the PMAL-R. For the discriminant validity, significant differences (p<0.05) were found between children with CP and typically developing children.</p><p>Conclusions</p><p>The results support that the OTCPDD is a reliable and valid observation-based assessment. The OTCPDD, which uses bimanual daily living activities, is able to represent the children’s general affected hand functions (including capacity, performance, and developmental disregard) in their daily routines.</p></div

Reliabilities of the Observatory Test of Capacity, Performance, and Developmental Disregard (OTCPDD).

<p>Reliabilities of the Observatory Test of Capacity, Performance, and Developmental Disregard (OTCPDD).</p

Demographic data of the children with cerebral palsy (CP) and the typically developing children (TDC).

<p>Demographic data of the children with cerebral palsy (CP) and the typically developing children (TDC).</p

Evaluating Functional Outcomes of Botulinum Toxin Type A Injection Combined with Occupational Therapy in the Upper Limbs of Children with Cerebral Palsy: A 9-Month Follow-Up from the Perspectives of Both Child and Caregiver

<div><p>Objective</p><p>To assess the effectiveness of combining botulinum toxin type A (BoNT-A) with functional occupational therapy (OT) at 9-month follow-up in children with cerebral palsy (CP) with bilateral upper limb impairments from the perspectives of both child and caregiver.</p><p>Methods</p><p>Twelve children with CP and their caregivers were assessed across 5 time points over 9 months based on the ICF after BoNT-A injection and functional OT in this open-label study.</p><p>Results</p><p>Significant differences were found across the 5 time points (<i>p</i> < .05) for both grasp and visual-motor integration with small effects (effect sizes = 0.12–0.24) and the self-care capability and performance of social function (<i>p <</i> .05). However, based on the effect sizes (0.02–0.14), no significant effects were found at the 4 post-test time points. Small effects were found on the psychological domain (effect sizes = 0.25–0.37) and environmental domains (effect size = 0.27) at follow-ups.</p><p>Conclusion</p><p>Combining a BoNT-A injection with OT not only reduced the muscle tone and increased ROM but also improved the upper limb function and self-care capability in children with CP. More importantly, these effects persisted for up to 9 months. Functional OT extends the effectiveness of a BoNT-A injection.</p></div

Characteristics of the participants (N = 12).

<p>Characteristics of the participants (N = 12).</p

The spasticity distribution of muscles for the botulinum toxin type A injection for each child.

<p>The spasticity distribution of muscles for the botulinum toxin type A injection for each child.</p

The dosage of botulinum toxin type A (Botox, onabotulinumtoxinA) injection in each muscle for each child.

<p>The dosage of botulinum toxin type A (Botox, onabotulinumtoxinA) injection in each muscle for each child.</p

ROM and spasticity changes from baseline after botulinum toxin type A injection.

<p>ROM and spasticity changes from baseline after botulinum toxin type A injection.</p