Conductive education for children with cerebral palsy: effects on hand motor functions relevant to activities of daily living. Export

@article{citeulike:4791723, abstract = {OBJECTIVE: To study the effects of conductive education, a combined educational and therapeutic task-oriented approach for children with cerebral palsy (CP), on their hand motor functions and activities of daily living (ADLs). DESIGN: Individual cohort study (B-A-B design). SETTING: Ambulatory, referral center. PARTICIPANTS: Sixty-four children with CP, severity Gross Motor Function Classification System levels II through IV, ages 3 to 6 years. INTERVENTIONS: Phases B: a 4.5-month period of special education, including 2 hours of individual physiotherapy or occupational therapy per week (special education). Phase A: during a 9-month period, conductive education was administered in 3 blocks of 4 weeks (7 hours daily from Monday through Friday); between the blocks, special education was applied as in the B phases. MAIN OUTCOME MEASURES: Transformed sum scores (0.00-1.00) for coordinative (eg, force-movement synergy during object manipulation, aiming) and for elementary hand functions (eg, maximum grip force, tapping), based on kinetic and kinematic measures; standardized parent questionnaire to measure ADL competence scores from 0.00 (dependence) to 1.00 (independence). Outcome parameters were changes in these parameters during phase A (intervention) compared with average changes during the B phases (pre- and postintervention). Student t tests were used for dependent samples. RESULTS: Conductive education improved coordinative hand functions by 20\% to 25\% from baseline, compared with no improvement during special education; the preferred hand improved from .38 to .48 (mean, .10; 95\% confidence interval [CI], .086-.114) and the nonpreferred hand improved from .39 to .47 (mean, .08; 95\% CI, .034-.116). There were no changes in elementary hand motor functions. ADL competence improved by .11 (95\% CI, .070-.149), from .50 to .61 ( approximately 20\%), compared with no significant improvement under special education. CONCLUSIONS: Conductive education improved coordinative hand functions and ADLs in children with CP. There was no effect on elementary hand functions.}, author = {Blank, R. and von Kries, R. and Hesse, S. and von Voss, H.}, citeulike-article-id = {4791723}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.apmr.2007.08.138}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18226648}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18226648}, doi = {10.1016/j.apmr.2007.08.138}, issn = {1532-821X}, journal = {Archives of physical medicine and rehabilitation}, keywords = {\_procedural\_interventions, \_pt, \_therapy, conductive\_education, intervention, mc\_movement\_cerebral\_palsy, treatment}, month = {February}, number = {2}, pages = {251--259}, posted-at = {2009-06-10 00:36:01}, priority = {2}, title = {Conductive education for children with cerebral palsy: effects on hand motor functions relevant to activities of daily living.}, url = {http://dx.doi.org/10.1016/j.apmr.2007.08.138}, volume = {89}, year = {2008} }

TY - JOUR ID - citeulike:4791723 L3 - citeulike-article-id:4791723 N2 - OBJECTIVE: To study the effects of conductive education, a combined educational and therapeutic task-oriented approach for children with cerebral palsy (CP), on their hand motor functions and activities of daily living (ADLs). DESIGN: Individual cohort study (B-A-B design). SETTING: Ambulatory, referral center. PARTICIPANTS: Sixty-four children with CP, severity Gross Motor Function Classification System levels II through IV, ages 3 to 6 years. INTERVENTIONS: Phases B: a 4.5-month period of special education, including 2 hours of individual physiotherapy or occupational therapy per week (special education). Phase A: during a 9-month period, conductive education was administered in 3 blocks of 4 weeks (7 hours daily from Monday through Friday); between the blocks, special education was applied as in the B phases. MAIN OUTCOME MEASURES: Transformed sum scores (0.00-1.00) for coordinative (eg, force-movement synergy during object manipulation, aiming) and for elementary hand functions (eg, maximum grip force, tapping), based on kinetic and kinematic measures; standardized parent questionnaire to measure ADL competence scores from 0.00 (dependence) to 1.00 (independence). Outcome parameters were changes in these parameters during phase A (intervention) compared with average changes during the B phases (pre- and postintervention). Student t tests were used for dependent samples. RESULTS: Conductive education improved coordinative hand functions by 20% to 25% from baseline, compared with no improvement during special education; the preferred hand improved from .38 to .48 (mean, .10; 95% confidence interval [CI], .086-.114) and the nonpreferred hand improved from .39 to .47 (mean, .08; 95% CI, .034-.116). There were no changes in elementary hand motor functions. ADL competence improved by .11 (95% CI, .070-.149), from .50 to .61 ( approximately 20%), compared with no significant improvement under special education. CONCLUSIONS: Conductive education improved coordinative hand functions and ADLs in children with CP. There was no effect on elementary hand functions. IS - 2 JF - Archives of physical medicine and rehabilitation SN - 1532-821X EP - 259 TI - Conductive education for children with cerebral palsy: effects on hand motor functions relevant to activities of daily living. VL - 89 SP - 251 KW - _procedural_interventions KW - _pt KW - _therapy KW - conductive_education KW - intervention KW - mc_movement_cerebral_palsy KW - treatment AU - Blank, R AU - von Kries, R AU - Hesse, S AU - von Voss, H PY - 2008/02// UR - http://dx.doi.org/10.1016/j.apmr.2007.08.138 ER -