Article

While adults with hemiplegic cerebral palsy (CP) can have significant
upper limb dysfunction, the effects of movement-based training has not been
investigated. OBJECTIVE: This uncontrolled trial assessed the effects of a home
and internet-based upper limb intervention program targeting motor and sensory
function. METHODS: Twelve adults, aged 21 to 57 yrs, GMFCS levels I-III with
asymmetric upper limb involvement participated in the Upper Limb Training and
Assessment (ULTrA) program. Clinical and functional measures included the Motor
Activity Log (MAL), the Nine-Hole Peg test, and grip strength. An upper limb
training system consisting of a laptop, webcam, target light board, and hand
manipulation/ discrimination devices was installed in each participant's home.
Training occurred 40 min/day, 5 days/wk for 8 wks and included both unilateral
and bilateral reach movements as well as a series of hand sensorimotor tasks such
as card turning, stereognosis, and tactile discrimination. Data generated during
each session were transmitted to the laboratory via the Internet. MAIN OUTCOME
MEASURES: were movement time, interlimb delay time, and performance on hand
sensorimotor tasks. RESULTS: Following training, affected limb reach movement
time decreased significantly for unilateral and bilateral tasks. Interlimb delay
during sequential reaching also decreased. Significant improvement in hand
manipulation tasks was also seen. Compliance was excellent and there were no
adverse effects. CONCLUSION: The ULTrA program had beneficial effects for adults
with CP and is safe and convenient to use. This system contrasts sharply with
programs with similar intent that require participant travel and hours of
therapist-based intervention.

Langue : ANGLAIS