Feasibility of gestural feedback treatment for upper extremity movement in children with cerebral palsy

Krista Coleman Wood, Corinna E. Lathan, Kenton R. Kaufman

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

External feedback of performance is an important component of therapy, especially for children with impairments due to cerebral palsy because they lack intrinsic experience of 'good movements' to compare effort and determine performance outcomes. A robotic therapy system was developed to provide feedback for specific upper extremity movements (gestures) which are therapeutically desirable. The purpose of this study was to compare changes in forearm supination/pronation or wrist extension/flexion motion following conventional therapy and gestural robotic feedback therapy intervention. Six subjects with cerebral palsy (ages 5-18, GMFCS level IV - three subjects, level III - one subject, and level I - two subjects) participated in a blinded crossover design study of conventional and robotic feedback therapy targeting either forearm supination or wrist extension. Functional upper extremity motion at baseline and following conventional and robotic feedback therapy interventions were obtained using a motion capture system by personnel blinded to the intervention order. All activities were approved by IRB. Use of the robotic feedback system did result in slightly increased movement in the targeted gesture without change in untargeted motions. Data also suggest a decrease in both agonist and antagonist motion following conventional therapy intervention. Results suggest improved motion when robotic feedback therapy intervention precedes conventional therapy intervention. Robotic feedback therapy is no different than conventional therapy to improve supination or wrist extension function in upper extremity impairments of children with cerebral palsy when changes were considered as aggregate data. In this very small group of diverse patients, individual subject results suggested that intervention order could be responsible for obscuring differences due to intervention type. Outcomes from several individual subjects suggest that results could be different given a more homogeneous group of subjects which future studies should be considered to ultimately determine efficacy of the robotic feedback therapy. Future studies should also address efficacy in other neuromuscular patient populations.

Original languageEnglish (US)
Article number6355692
Pages (from-to)300-305
Number of pages6
JournalIEEE Transactions on Neural Systems and Rehabilitation Engineering
Volume21
Issue number2
DOIs
StatePublished - 2013

Keywords

  • Cerebral palsy (CP)
  • movement feedback
  • robotic feedback
  • upper extremity

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biomedical Engineering
  • Computer Science Applications

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