Task-oriented training (TOT) improves hand dexterity in children with cerebral palsy (CP), according to a preliminary study from South Korea.
The research, titled “The effects of task-oriented training on hand dexterity and strength in children with spastic hemiplegic cerebral palsy: a preliminary study,” was published in the Journal of Physical Therapy Science and was led by researchers at Gachon University, Incheon, South Korea.
Children with CP often show delayed development, impaired body movement, and limitations in daily living activities.
About 36 percent of all cerebral palsy cases are of the spastic type (affected with spasms). Children with hemiplegic CP (those with damage in the brain hemisphere controlling movement) suffer from sensory deficit, spasticity, and muscle weakness, which significantly affects the upper limb, reduces motor control, and decreases the efficiency of hand function. These limitations complicate routine activities, such as dressing and feeding.
Research has shown that various interventions help ease the function of the upper limb and hand in children with cerebral palsy. These include sensory integration, neurodevelopmental treatment, and constraint-induced movement therapy. But among these interventions, task-oriented training has been the treatment strategy most often selected to improve functional movement.
TOT leads to benefits in gait and upper limb function in stroke patients, as well as in mobility in children with CP. But little is known regarding the effects of TOT on upper limb function in children with spastic hemiplegic cerebral palsy.
Therefore, researchers analyzed the effects of task-oriented training on hand dexterity and grip strength in these children.
The study enrolled a total of 12 children who were assigned to either TOT or a control group. Both groups received conventional occupational therapy 40 minutes a day, two times a week, for four weeks. Children in the TOT group also received task-oriented training for 20 minutes.
Tasks in the TOT group focused on improving upper limb function, such as “repeated reaching, ring activity, and stacking cups to catch the target using a paretic hand” (with slight paralysis), the researchers wrote. Children received feedback from the therapist so they could train when they wanted.
Results showed that children in the TOT group improved hand dexterity after the intervention. No significant improvement was seen in grip strength, but the team suggests that increasing the therapy time may result in a significant improvement in grip strength, as well.
No significant improvements were observed in hand dexterity or grip strength in the control group.
Overall, the study “demonstrated that TOT with conventional rehabilitation significantly improves hand dexterity. Therefore, TOT should be provided in the rehabilitation of children with spastic hemiplegic CP,” the researchers concluded.
The team emphasized that additional studies should confirm these results in a larger sample size and for a longer period of time.
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