Cognition and bimanual performance in children with unilateral cerebral palsy: Protocol for a multicentre, cross-sectional study

© 2018 The Author(s). Background: Motor outcomes of children with unilateral cerebral palsy are clearly documented and well understood, yet few studies describe the cognitive functioning in this population, and the associations between the two is poorly understood. Using two hands together in daily life involves complex motor and cognitive processes. Impairment in either domain may contribute to difficulties with bimanual performance. Research is yet to derive whether, and how, cognition affects a child's ability to use their two hands to perform bimanual tasks. Methods/Design: This study will use a prospective, cross-sectional multi-centre observational design. Children (aged 6-12 years) with unilateral cerebral palsy will be recruited from one of five Australian treatment centres. We will examine associations between cognition, bimanual performance and brain neuropathology (lesion type and severity) in a sample of 131 children. The primary outcomes are: Motor - the Assisting Hand Assessment; Cognitive - Executive Function; and Brain - lesion location on structural MRI. Secondary data collected will include: Motor - Box and Blocks, ABILHAND- Kids, Sword Test; Cognitive - standard neuropsychological measures of intelligence. We will use generalized linear modelling and structural equation modelling techniques to investigate relationships between bimanual performance, executive function and brain lesion location. Discussion: This large multi-centre study will examine how cognition affects bimanual performance in children with unilateral cerebral palsy. First, it is anticipated that distinct relationships between bimanual performance and cognition (executive function) will be identified. Second, it is anticipated that interrelationships between bimanual performance and cognition will be associated with common underlying neuropathology. Findings have the potential to improve the specificity of existing upper limb interventions by providing more targeted treatments and influence the development of novel methods to improve both cognitive and motor outcomes in children with unilateral cerebral palsy

Minimising impairment: Protocol for a multicentre randomised controlled trial of upper limb orthoses for children with cerebral palsy.

BACKGROUND: Upper limb orthoses are frequently prescribed for children with cerebral palsy (CP) who have muscle overactivity predominantly due to spasticity, with little evidence of long-term effectiveness. Clinical consensus is that orthoses help to preserve range of movement: nevertheless, they can be complex to construct, expensive, uncomfortable and require commitment from parents and children to wear. This protocol paper describes a randomised controlled trial to evaluate whether long-term use of rigid wrist/hand orthoses (WHO) in children with CP, combined with usual multidisciplinary care, can prevent or reduce musculoskeletal impairments, including muscle stiffness/tone and loss of movement range, compared to usual multidisciplinary care alone. METHODS/DESIGN: This pragmatic, multicentre, assessor-blinded randomised controlled trial with economic analysis will recruit 194 children with CP, aged 5-15 years, who present with flexor muscle stiffness of the wrist and/or fingers/thumb (Modified Ashworth Scale score =1). Children, recruited from treatment centres in Victoria, New South Wales and Western Australia, will be randomised to groups (1:1 allocation) using concealed procedures. All children will receive care typically provided by their treating organisation. The treatment group will receive a custom-made serially adjustable rigid WHO, prescribed for 6 h nightly (or daily) to wear for 3 years. An application developed for mobile devices will monitor WHO wearing time and adverse events. The control group will not receive a WHO, and will cease wearing one if previously prescribed. Outcomes will be measured 6 monthly over a period of 3 years. The primary outcome is passive range of wrist extension, measured with fingers extended using a goniometer at 3 years. Secondary outcomes include muscle stiffness, spasticity, pain, grip strength and hand deformity. Activity, participation, quality of life, cost and cost-effectiveness will also be assessed. DISCUSSION: This study will provide evidence to inform clinicians, services, funding agencies and parents/carers of children with CP whether the provision of a rigid WHO to reduce upper limb impairment, in combination with usual multidisciplinary care, is worth the effort and costs. TRIAL REGISTRATION: ANZ Clinical Trials Registry: U1111-1164-0572

Learning by doing: Lessons learned on explicit and implicit motor learning in children

Contains fulltext : 219701.pdf (publisher's version ) (Open Access)Radboud University, 06 juli 2020Promotores : Steenbergen, B., Nijhuis-van der Sanden, M.W.G.194 p

Dataset bean bag throwing, explicit and implicit learning in children

Dataset manuscript 'Learning bean bag throwing: a comparison of explicit, error-strewn, learning and implicit, error-reduced, learning in 5- to 8-year-old children' The study was set-up to elucidate differences between explicit, error-strewn learning and implicit, error-reduced learning in learning a gross motor task (underhand beanbag throwing) in children and to assess the role of working memory in these forms of learning. Typically developing children (n=37) of 5-8 years participated in a three-day underhand throwing training program in a pre- and post-test design and were assigned either to an explicit learning (error-strewn) or implicit learning (error-reduced) group. The effectiveness of the different learning conditions was assessed by the number of hits and quality of the aiming movement. For more information see methodology section in the attached files

Dataset bean bag throwing, explicit and implicit learning in children

Dataset manuscript 'Learning bean bag throwing: a comparison of explicit, error-strewn, learning and implicit, error-reduced, learning in 5- to 8-year-old children' The study was set-up to elucidate differences between explicit, error-strewn learning and implicit, error-reduced learning in learning a gross motor task (underhand beanbag throwing) in children and to assess the role of working memory in these forms of learning. Typically developing children (n=37) of 5-8 years participated in a three-day underhand throwing training program in a pre- and post-test design and were assigned either to an explicit learning (error-strewn) or implicit learning (error-reduced) group. The effectiveness of the different learning conditions was assessed by the number of hits and quality of the aiming movement. For more information see methodology section in the attached files

Norm scores of the box and block test for children ages 3-10 years

Item does not contain fulltextThis study provides new norm scores for the Box and Block Test for gross manual dexterity in children ages 3-10 yr. Two hundred fifteen Dutch children performed the Box and Block Test separately with each hand. We found an age effect for the scores; older children obtained higher scores than younger children. Concurrent validity was assessed by means of comparison with the manual dexterity subtests of the Movement Assessment Battery for Children-2; correlations were significant. Intraclass correlation coefficients for test-retest and interrater reliability measures were .85 and .99, respectively. The Box and Block Test is an easy, feasible, valid, and reliable measurement for gross manual dexterity in young children. The obtained norms can be used in clinical settings to compare the gross manual dexterity of atypically developing children with that of age-related peers and to evaluate efficacy of interventions. A larger international reference population is needed to increase generalizability

Explicit and implicit motor sequence learning in children and adults: The role of age and visual working memory

This study investigated explicit and implicit motor learning, and the influence of visual working memory (VWM) and age. Sixty children and 28 adults learned a nine-button sequence task explicitly and implicitly. Performance in explicit and implicit learning improved with age. Learning curves were similar across ages for implicit learning. In explicit learning, learning curves differed across ages: younger children started slower, but their learning rate was higher compared to older children. Learning curves were similar across VWM scores, but performance in explicit learning was positively influenced by VWM scores. Further research and implications for education and rehabilitation are discussed

Measurement of action planning in children, adolescents, and adults: A comparison between three tasks

Contains fulltext : 167935.pdf (publisher's version ) (Closed access)7 p