Poster #139 - Development of a 6-week, researcher-caregiver co-delivered, home-based, training program using joystick-operated ride-on-toys to promote recovery of upper extremity function in children with hemiplegic cerebral palsy (HCP)

• In Event: Poster Session 09

Abstract

Introduction: Children with hemiplegic Cerebral Palsy (HCP) face significant impairments in upper extremity (UE) function that warrant long-term interventions to promote functional recovery. It is crucial to ensure child buy-in to therapy to facilitate sustained engagement and adherence with rehabilitation. Across 2 pilot studies conducted within an existing summer camp, we found that joystick-operated ride-on-cars (ROCs) may serve as enjoyable and motivating tools that can promote children with HCP to use their affected UE for purposeful and goal-directed navigation tasks. In the present study, we propose to develop a researcher-clinician co-delivered home-based ROC navigation training program to promote use of UE in children with HCP.
Methods: The development of the home-based intervention will be based on our past pilot studies, on the literature on evidence-based, task-oriented approaches to improve upper extremity function in children with HCP, and based on inputs from stakeholders including therapists (physical and occupational therapists), caregivers, and children. The intervention will be based on principles of motor learning and will involve variable practice, discovery learning, trial-and-error learning, active problem solving, progressive challenges tailored to child needs, immediate visual and auditory feedback, and playful exploration. Each session will have periods of “structured play” and “free play”. Training will require gross motor UE movements (shoulder, elbow, and wrist movements to move the joystick in different directions – forward, backward, left, and right) and include fine motor activities (grasp and control the joystick, pick up/pull/push/throw props, lift and manipulate different types of props like koosh balls, bean bags, cups, blocks, etc. during navigational games). Training activities will be progressed weekly to increase the navigational challenge (straight path, circular path, slalom path, mazes, obstacle avoidance tasks, timed challenges, etc.) and the movement control challenge (increase in required range of UE movements, muscle force control, and manual dexterity for completion of tasks). We will collect feedback on the program from therapists, caregivers, and children.
Expected results: We will report on the intervention development process and the proposed home-based intervention program. We will also report on stakeholder input during the intervention development process. We will report on pilot data on feasibility of intervention implementation/delivery and feedback from children and caregivers on enjoyment and perceived efficacy of the program.

Conclusion: Our work has implications for the use of joystick-operated ROCs as enjoyable, child-friendly tools that can be used by caregivers at home and within the child’s naturalistic settings to encourage children with HCP to use their affected UE for functional, goal-oriented tasks.

Authors

• Vaishnavi Sandeep Shahane, University of Connecticut
  Presenting Author

• Sarah Sullivan

• Patrick Kumavor

• Kristin Morgan

• Sudha M Srinivasan, University of Connecticut