Article

This study tested in children with cerebral palsy (CP) whether motor
habilitation resembles motor learning. METHODS: Twelve children with hemiplegic
CP ages 5 to 12 years with moderate to severe motor impairments underwent a
16-session robot-mediated planar therapy program to improve upper limb reach,
with a focus on shoulder and elbow movements. Participants were trained to
execute point-to-point movements (with robot assistance) with the affected arm
and were evaluated (without robot assistance) in trained (point-to-point) and
untrained (circle-drawing) conditions. Outcomes were measured at baseline,
midpoint, immediately after the program, and 1 month postcompletion. Outcome
measures were the Fugl-Meyer (FM), Quality of Upper Extremity Skills Test
(QUEST), and Modified Ashworth Scale (MAS) scores; parent questionnaire; and
robot-based kinematic metrics. To assess whether learning best characterizes
motor habilitation in CP, the authors quantified (a) improvement on trained tasks
at completion of training (acquisition) and 1 month following completion
(retention) and (b) quantified generalization of improvement to untrained tasks.
RESULTS: After robotic intervention, the authors found significant gains in the
FM, QUEST, and parent questionnaire. Robot-based evaluations demonstrated
significant improvement in trained movements and that improvement was sustained
at follow-up. Furthermore, children improved their performance in untrained
movements indicating generalization. CONCLUSIONS: Motor habilitation in CP
exhibits some traits of motor learning. Optimal treatment may not require an
extensive repertoire of tasks but rather a select set to promote generalization.

Langue : ANGLAIS