Affiliations: [a] Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| [b] Department of Rehabilitation, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| [c] Department of Physiotherapy, Aneurin Bevan University Health Board, Newbridge, UK
| [d] Prince Mansour Military Hospital Al Faisaliyyah, Taif, Saudi Arabia
Correspondence:
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Address for correspondence: Dr. Amitesh Narayan, Professor, Department of Physiotherapy Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001, India. E-mail: amitesh.narayan@manipal.edu; ORCID: https://orcid.org/0000-0001-7587-8414.
Abstract: BACKGROUND:In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills. OBJECTIVE:This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities. METHODS:The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49–72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded. RESULTS:The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively. CONCLUSION:The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.
Keywords: Cerebral palsy, hand rehabilitation, fine motor skills, peabody developmental scale (PDMS-2), novel hand rehabilitation (NHR) board
