Article

The properties of the mirror neuron system suggest a new type of
upper limb (UL) rehabilitation in children with unilateral cerebral palsy (UCP),
based on observation of action therapy followed by execution of a variety of
observed movements (AOT). OBJECTIVE: We tested the effects of AOT in the Upper
Limb Children Action Observation Training (UP-CAT) trial. METHODS: In a
randomized, evaluator-blinded, block-designed trial, 24 UCP children with mild to
moderate hand impairment were assigned to 2 groups. The experimental group
observed, 1 hour per day for 3 consecutive weeks, video sequences of unimanual or
bimanual goal-directed actions and subsequently executed observed actions with
the hemiparetic UL or both ULs. The control group performed the same actions in
the same order as the experimental sample, but had watched computer games. The
Assisting Hand Assessment (AHA) scale was the primary outcome measure; the
Melbourne assessment and ABILHAND-Kids were secondary ones. Outcomes were
assessed at 1 week (T1), 8 weeks (T2), and 24 weeks (T3) after the end of the
training. RESULTS: The experimental group improved more (P = .008) in score
changes for the AHA at the primary endpoints T1 (P = .008), T2 (P = .019), and T3
(P = .049). No between-group significant changes were found for ABILHAND-Kids or
Melbourne assessment. CONCLUSIONS: UP-CAT improved daily UL activities in UCP
children, suggesting a new rehabilitation approach based on a neurophysiological
model of motor learning.

Langue : ANGLAIS