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The Effect of Intermanual Training of the Hand on Skill Generalization in Infantile Spastic Hemiplegic Cerebral Palsy


Affiliations
1 M.M Institute of Physiotherapy and Rehabilitation, Mullana, Ambala, India
     

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Background: Cerebral palsy is the most common pediatric neurological problem, affecting the total development of the child either directly, relating to sensory motor function, or indirectly through associated problems including Nystagmus, seizure disorders etc. Among various physical impairments, loss of hand function has a profound effect on individual's life. Hence, hand rehabilitation becomes an important therapeutic goal in these patients (13).

Objective: To examine the effects of intermanual training of hand on skill generalization in infantile Spastic Hemiplegic Cerebral palsy.

Methods: A group of 40 subjects will be selected according to the inclusion and exclusion criteria. Preintervention measures outcome parameters will be Fugl Meyer Scale, Hand- held Dynamometer and Time taken to complete the task and No. of Pegs placed using left hand in 30 seconds were noted and No. of Cheese cubes dropped (Error) in chop sticks and spoon activities.

Result: The study consisted of two groups, A (Experimental) and B (Control). Each group consisted of 15 subjects. Parametric statistic was used to compare the left hand performance, in terms of time taken. Member of errors and number of pegs, on spoon and square pegboard activity before and after the inter manual training to right hand. Pre and post date of left hand performance were analyzed with paired t-test within groups and unpaired t-test was used to compare pre and post date between groups. The significant level of the test was set at P<0.05.

Conclusion: The findings from this study suggest that in a sample of childhood stroke patients, intermanual transfer effects occur in terms of performance duration and number of errors during occupationally embedded tasks.


Keywords

Intermanual Training, Spasticity, Cerebral Palsy
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  • Agre. J.C.et al: Strength testing with a portable dynamometer. Reliability for upper and lower extremities. Arch Phy Med Rehabil 68:454,1987.

  • Alexander Lenhard and Joachin Hoffman, Intermanual learning transfer.

  • Browm O.A. Kautz S.A. Increased work load enhances force output during pedaling exercise in person with post stroke hemiplegic. Stroke29, 1998:598-606.

  • Duncan P.W. Stroke Disability. Physical Therapy 1994:24:399-407.

  • Elliot Hazeltine, Wesely K. Nurses and Richard BIvry (2003). Journal of Neurophysiology 90:2409-2418:The role of corpus callosum in the bimanual isometric force pulses.

  • F.A.Hellabrant, M.D.Annie M Panish B.S.(1947). Archives of Physical Medicine, February- The influence of unilateral exercises on the contralatreal limb.

  • Folstein M.F. et al: Mini Mental Scale- A practical method for grading the cognitive state of patients for the clinicians. J of Psychiatry Res 12:189-198, 1975.

  • G.Tassinari, S.Aglioti,R.Pallini, G.Beluichi. Behavioral Brain Research (1994) 64:141-49. Interhemispheric integration of simple visuomotor responses in patients with partial collasal defects.

  • Greogor Thut, Ulrike Halsband (1997) Behavioral Brain Research,89 129-134, Intermanual transfer of training, blood flow correlates in the human brain.

  • H. Van Mier, L.W.Temple, J.S.Perlmutter, M.E. Raichle and S.E. Peterson. Journal of Neurophysiology. Changes in brain activity during motor learning measured with PET: Effects of hand of performance and practice.

  • H.P. Adams Jr Handbook of Cerebrovascular disease. Marcel Dekkan Inc NY, 1993.

  • Hemispheric asymmetry and interhemispheric transfer in reaching programming. Neuropsychologis, 1999 July 37(8) 895-903.

  • Huang ME, Cifu DX, Keyser- Marcus L (1998). Functional outcome after brain tumor and acute stroke: A comparative analysis. Arch Phys Med Rehabil Nov 79(11):1386-90.

  • Journal of Neurophysiology (2003) 89:168-178-Learned dynamics of reaching movements generalize from dominant to non dominant arm.

  • Liepmann H. Motor apraxia, anarthia and apraxia .Translations of the 17th International congress of medicine (London) Section XI, part 2, 97-106, 1913.

  • Mara Fabri, Maria Del Pesce (2001). Journal of cognitive Neuroscience 13(8) 1071-79. Posterior corpus callosum and inter hemispheric transfer of somatosensory information: A functional M.R.I. and neuropsychological study of a partially collosotomised patient.

  • Medicine and Science in Sports and Exercise 37(9) 1594-1600, Sep (2005) Cross education of arm, muscular strength in unidirectional in right handed individual.

  • R.C.Old field. Neuropsychlogia (1971): vol 9: 99- 113. The analysis of handedess; The Edinburg Inventory.

  • Sophie Vanghelume, Veerla Puttemans. Behavioural Brain Research, 154(2004)534-547. Inter and Intra limb transfer of a bimanual task – generalization of limb dissociation.

  • Susan B. O.’ Sullivan. Physical Rehabilitation.

  • Teixeira.L.A. Brain Cognition (2000) Dec 44 (3) 455-69: Timings and force component in bilateral transfers of training.

  • The Fugl-Meyer assessment of motor recovery after stroke: A critical review of its measurement properties. Neurorehabilitation and Neural Repair Vol 16, (3), 232-240 (2000).

  • Ulf. Ziemann, Kenji Ishii, Alessandra Bargheresi. Journal of Physiology (1999) 518(3), 897-906. Dissociation of pathways mediating ipsilatreal and contralatreal motor evoked potentials in human hand and arm muscles.


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  • The Effect of Intermanual Training of the Hand on Skill Generalization in Infantile Spastic Hemiplegic Cerebral Palsy

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Authors

Deepmala
M.M Institute of Physiotherapy and Rehabilitation, Mullana, Ambala, India
Sudha Arora
M.M Institute of Physiotherapy and Rehabilitation, Mullana, Ambala, India

Abstract


Background: Cerebral palsy is the most common pediatric neurological problem, affecting the total development of the child either directly, relating to sensory motor function, or indirectly through associated problems including Nystagmus, seizure disorders etc. Among various physical impairments, loss of hand function has a profound effect on individual's life. Hence, hand rehabilitation becomes an important therapeutic goal in these patients (13).

Objective: To examine the effects of intermanual training of hand on skill generalization in infantile Spastic Hemiplegic Cerebral palsy.

Methods: A group of 40 subjects will be selected according to the inclusion and exclusion criteria. Preintervention measures outcome parameters will be Fugl Meyer Scale, Hand- held Dynamometer and Time taken to complete the task and No. of Pegs placed using left hand in 30 seconds were noted and No. of Cheese cubes dropped (Error) in chop sticks and spoon activities.

Result: The study consisted of two groups, A (Experimental) and B (Control). Each group consisted of 15 subjects. Parametric statistic was used to compare the left hand performance, in terms of time taken. Member of errors and number of pegs, on spoon and square pegboard activity before and after the inter manual training to right hand. Pre and post date of left hand performance were analyzed with paired t-test within groups and unpaired t-test was used to compare pre and post date between groups. The significant level of the test was set at P<0.05.

Conclusion: The findings from this study suggest that in a sample of childhood stroke patients, intermanual transfer effects occur in terms of performance duration and number of errors during occupationally embedded tasks.


Keywords


Intermanual Training, Spasticity, Cerebral Palsy

References