Feasibility of Developing Audiovisual Material for Training Needs in a Vietnam Orphanage: A Mixed-Method Design.

Disabled children living in orphanages in low-income countries may not have access to the therapy they need. The COVID-19 pandemic has complicated the situation dramatically, making online training activities a possible innovative option to meet the real needs of local staff. This study aimed to detect the training needs of the local staff of an orphanage in Vietnam, as well as develop an audiovisual training material and measure its feasibility. Training needs were identified through a focus group carried out by the volunteers of Fisios Mundi, a nongovernmental organization. The audiovisual training material was developed to meet these specific needs. Lastly, its feasibility was evaluated, in terms of both content and format, through an ad hoc questionnaire. Nine volunteers participated in the project. Twenty-four videos were created and structured around five themes. This study expands the body of knowledge on how an international cooperation project can be developed in a pandemic situation. The audiovisual training material content and format created in this project was considered by the volunteers as very feasible and useful for training the staff of a Vietnamese orphanage.

Somatosensation and motor performance in the less-affected and more-affected hand of unilateral cerebral palsy children: a cross-sectional study.

PURPOSE: This study aimed to examine motor performance and somatosensory processing of unilateral cerebral palsy (UCP) children in both the less-affected hand and the more-affected hand. This study is also aimed at analysing the somatosensory proccessing in the more-affected hand in relation to age and damaged hemisphere. MATERIALS AND METHODS: Forty-seven children aged from 6 to 15 years (UCP = 23; TD = 24) were recruited. Grip strength, pinch strength, Box and Block Test and Jebsen Taylor Hand Function Test were used to analyse motor performance. A comprehensive somatosensory assessment battery was included: tactile registration, unilateral, bilateral and spatio-temporal perception, haptic recognition, texture perception, proprioception, pressure pain threshold and functional sensitivity. RESULTS: UCP children exhibited lower performance in all aspects of motor performance measured in both the less-affected hand and the more-affected hand, except grip strength in the less-affected hand. Significant differences were found for all tests included in the somatosensory assessment in both the less-affected hand and the more-affected hand, except unilateral perception tests in the less-affected hand. CONCLUSIONS: UCP children present difficulties in motor performance and somatosensory processing not only in the more-affected hand, but also in the less-affected hand. Somatosensation may be a critical driver of functional performance.Implications for rehabilitationThe less-affected hand of children with unilateral cerebral palsy should be included in both assessment and intervention programmes.Somatosensory processing should be assessed through a comprehensive battery, both in the less-affected hand and in the more-affected hand of unilateral cerebral palsy children.Somatosensory treatment must be taken into account if functional performance in the activities of daily living of unilateral cerebral palsy children is to be improved.

Combined intensive therapies at home in spastic unilateral cerebral palsy with high bimanual functional performance. What do they offer? A comparative randomised clinical trial.

BACKGROUND: Children with unilateral spastic cerebral palsy (USCP) receive different treatments, including the application of modified constraint induced movement therapy (mCIMT) or bimanual intensive therapy (BIT) to increase affected upper limb functionality. The aim of this study was to compare the effectiveness of two protocols with different proportions and orders of mCIMT/BIT within combined intensive home-therapy in children with USCP (6-8 years old) with high bimanual functional performance, applied by the family. METHODS: The protocols were performed on 20 children with an average age of 7.12 years [standard deviation (SD): 0.70], allocated to two different combined therapies. The protocols were designed by 100 h of dose for 10 weeks: 80 h of mCIMT followed by 20 h of BIT (mCIMT-B group) and 80 h of BIT followed by 20 h of mCIMT (BIT-mCI group). Bimanual functional performance was measured with Assisting Hand Assessment Scale (AHA) and the affected upper limb-use experience with Children's Hand-use Experience Questionnaire (CHEQ). Parent satisfaction and expectations with therapy were measured using a specific questionnaire. There were five assessment timepoints (week 0, week 4, week 8, week 10 and week 34). RESULTS: There were no statistically significant (p > 0.05) inter- and intra-group changes in the bimanual functional performance of both groups. The affected upper limb-use experience obtained significant changes in BIT-mCI group, with statistically significant differences in the pairwise comparisons between week 0-10 and week 4-10 (p = 0.028) for use of the affected hand and the use of the affected hand to grasp between week 4 and week 8 (p = 0.028). Grasp efficacy and discomfort acquired statistically significant differences only in the BIT-mCI group for pairwise comparisons week 0-week 10/week 4-week 10 (p = 0.035). Although task execution time compared with a typically developing child of the same age obtained statistically significant differences only in the group mCIMT-B for pairwise comparisons week 0-week 8 (p = 0.03), week 0-week 10 (p = 0.03), week 4-week 8 (p = 0.04) and week 4-week 10 (p = 0.03). Family satisfaction and expectations acquired an increase between week 0 and week 10 (p ⩽ 0.02). CONCLUSION: Applying 80 h of BIT for 8 weeks in children with high bimanual functional performance USCP (6-8 years old), executed at home with family involvement would be sufficient to obtain improvements in affected upper limb-use experience, without the need to use combined protocols of 100 h. However, no statistically significant increase in bimanual functional performance would be obtained, with the basal situation of the child being a factor to consider for the execution of mCIMT and BIT.Registration number and name of trial registry: [ClinicalTrials.gov identifier: NCT03465046].

Sensory Processing, Functional Performance and Quality of Life in Unilateral Cerebral Palsy Children: A Cross-Sectional Study.

BACKGROUND: The study of children with unilateral cerebral palsy (UCP) has traditionally focused on motor aspects. The extent to which sensory processing disorders can affect their functional performance and quality of life (QoL) is uncertain. This study aimed to explore the differences in sensory processing between UCP and typical development (TD) children and to analyze the relationship of sensory processing with functional performance and QoL. METHODS: Fifty-three children aged from 6 to 15 years (TD = 24; UCP = 26) were recruited. The Child Sensory Profile 2, Pediatric Evaluation of Disability Inventory-Computer Adaptive Test and Kidscreen were used to evaluate sensory processing, functional performance and QoL. RESULTS: UCP children showed sensory processing difficulties (avoidance: p = 0.02; registration: p = 0.00; body position: p = 0.00; oral: p = 0.02; social-emotional: p = 0.01), and scored lower in functional performance (daily activities: p = 0.00; mobility: p = 0.00; social/cognitive: p = 0.04) and in physical well-being (p = 0.00). The highest correlations in UCP group were found between proprioceptive processing and daily activities and mobility (r = -0.39); auditory, visual and tactile information and school environment (r = -0.63; r = -0.51; r = -0.46); behavioral and social-emotional responses and psychological well-being (r = -0.64; r = -0.49). CONCLUSIONS: UCP children have greater difficulty in sensory processing than TD children. Difficulties in proprioceptive processing contribute to poorer functional performance. Auditory, visual and tactile processing is associated with participation in the school environment and behavioral and social-emotional responses related to sensory processing are associated with the psychological well-being.

Uso terapéutico del aprendizaje de un idioma / The therapeutic use of language learning

A través de los ojos de dos estudiantes de Terapia Ocupacional durante una beca Erasmus llevada a cabo en un psiquiátrico en Bélgica, se realiza un análisis de la actividad: aprender un idioma como parte de la terapia de pacientes en el área de la salud mental. Se ponen de manifiesto todos los aspectos que se pueden trabajar (habilidades cognitivas, relaciones interpersonales y sociabilidad, comunicación, autoestima, función ocupacional y la incidencia de las alucinaciones auditivas), y cómo todos ellos surgen de manera natural cuando se lleva a cabo el aprendizaje de un idioma. Veremos cómo una actividad propositiva y significativa para el paciente se convierte en una actividad terapéutica.

From two Occupational Therapy´s students point of view during an Erasmus in a psychiatric in Belgium, the article explain an an anlysis of: “language learning” as a part into a therapy with patients in mental health. The article tries to show all aspects we can develop in patients (cognitive skills, interpersonal relations and social ability, self steem, occupational functioning and how to mitigate auditive hallucinations), and how all of them come up in a natural way during a language learning. In conclusion how a meaningful activity to the patient became in a therapeutic activity.

Experiencia e ilusión: una rehabilitación pediátrica en polonia / Experience and hope: a pediatric rehabilitation in poland

En los orfanatos Polacos encontramos niños que sufren una situación de profunda injusticia ocupacional. Dentro de un entorno privado de estímulos externos, tanto afectivos como educativos, analizamos una situación que desencadena un retraso en su desarrollo motor e intelectual, al que debemos sumar en algunos casos enfermedades congénitas. El presente artículo pretende mostrar, bajo el punto de vista de un grupo de jóvenes y basándonos en una experiencia vivencial, la rehabilitación de estos niños a través de una gran diversidad de técnicas que consideramos útiles desde el punto de vista de la Terapia Ocupacional.

In the polish orphanages we can find children in an occupational apartheid hard situation. Within an environment without external stimulus, not only affective but also educational stimulus, we try to analyse a situation that can bring us to a delay in the motor and intellectual development. Moreover, we will also have to take into account in some cases congenital illness. This article tries to show, from a group of young people point of view and from their experience, the rehabilitation of these children by using a great diversity of techniques with are useful from an occupational therapy point of view.