Efficacy of constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy in an educational setting.

We examined the efficacy of modified constraint-induced movement therapy (CIMT) and hand-arm bimanual intensive therapy (HABIT) in a special education preschool/kindergarten in Israel. Twelve children (1.5-7 years) with congenital hemiplegic cerebral palsy were randomized to receive modified CIMT (n = 6) or HABIT (n = 6). Occupational and physical therapists administered usual and customary care for 8 weeks; children then crossed over to receive CIMT or HABIT 2 hr/day, 6 days/week for 8 weeks from their occupational therapist. The Assisting Hand Assessment and Quality of Upper Extremity Skills Test were administered 2 months prior to the intervention, immediately before, immediately after intervention, and 6 months after the first baseline assessment. Both groups demonstrated no change during baseline and comparable improvement following CIMT and HABIT (p < .001), which was maintained at 6-month follow-up. Results suggest that modified CIMT and HABIT provided in school-based settings can lead to improvements in quality of bimanual skill and movement patterns.

Interprofessional online course for telehealth delivery of pediatric developmental services.

PURPOSE: This study aimed to examine the effectiveness of an interprofessional telehealth course developed based on a collaborative needs assessment of professionals working in community-based child-development units. MATERIALS AND METHODS: Ninety-six pediatric therapists, including psychologists, social workers, speech-language pathologists, physiotherapists, and occupational therapists, participated in a 10-week, 30-hour online training on best practices in telehealth delivered according to adult learning theory guidelines. Participants reported their telehealth competencies before and after the training using a questionnaire developed for the study. RESULTS: Repeated paired t-tests showed significant increases with high effect sizes in participants' knowledge, attitudes, emotions, and willingness to use telehealth in their practices. However, at follow-up, the implementation rates remained low. CONCLUSIONS: Online learning tailored to learners' needs can change knowledge, attitudes, and willingness to incorporate telehealth into routine care. Collaboration among regulators, foundations, professional associations, and clients attuned to health care's changing needs is essential to providing solutions and boosting the quality of rehabilitation services. However, providing knowledge alone is not enough: Sustainable implementation planning is essential for knowledge translation.IMPLICATIONS FOR REHABILITATIONTelehealth can enhance access to rehabilitation services, but providers require training to promote knowledge, attitudes, and willingness to incorporate telehealth into routine care.Effective training should be based on collaboration among all stakeholders, from needs assessment and content development to implementation and devising a plan to translate sustainable knowledge into rehabilitation.Training courses should combine content on best practices with a delivery approach based on adult learning principles.To translate knowledge into practice, the course must be a part of a sustainable implementation plan at the workplace.

Auditory stimulation improves motor function and caretaker burden in children with cerebral palsy- A randomized double blind study.

AIM: To investigate the impact of auditory stimulation on motor function in children with cerebral palsy (CP) and disabling hypertonia. METHOD: 9 matched pairs (age: 7y5m, SD 4y1m; 13 boys; gross-motor-functional-classification-scale: median 4; manual-ability-classification-system: median 4) were randomized to receive either auditory stimulation embedded in music (study, n = 9) or music alone (sham, control, n = 9) for at least 10 minutes 4 times a week for 4 weeks. Goal-Attainment-Scale, Care-and-Comfort-Hypertonicity-Questionnaire, Gross-Motor-Function-Measure and Quality-of-Upper-Extremity-Skills-Test (QUEST) were assessed before and 5 months following intervention. RESULT: Children receiving auditory stimulation attained more goals than children who listened to music alone (p = 0.002). Parents reported improved care and comfort in children in the study group compared to a slight deterioration in controls (p = 0.002). Upper extremity skills improved in the study group compared to controls (p = 0.006). Similar gross motor function changes were documented in both groups (p = 0.41). One participant reported increased seizure frequency; no other participants with epilepsy reported increased seizure frequency (n = 6/18) and no other adverse events were reported. INTERPRETATION: Auditory stimulation alleviated hypertonia and improved fine and gross motor functions.