Cimolin et al.

(2012)

Italy

PCT

N=20

Population: TBI; Hemiplegia TBI Group (n=10): Mean Age=9.8yr; GCS Range=4-8. Healthy Controls (n=10): Age Range=7.3-13.6yr.

Intervention: The Hemiplegia TBI Group was asked to wear a fabric glove with a built-in, stiff plastic volar splint on the unaffected hand, which prevented them from flexing their fingers and prevented their ability to grasp. The glove was worn 3 hr/day during which both groups participated in rehabilitation activities including playing cards, completing puzzles, using a spoon or fork, and dusting a surface. The Control group did not receive any type of treatment. The intervention was provided 7 days/wk for a total of 10 wk with rehabilitation activity sessions provided 3/wk. Assessments were completed at baseline and post-treatment.

Outcome Measure: Quality of Upper Extremities Skills Test (QUEST), Gross Motor Function Measure (GMFM), Besta Scale (BS), Total Movement Duration (TMD), Mean Movement Velocity (MMV), Range of Motion (ROM), Average Jerk Index (AJ), Average Sway Index (AS).

1.        All participants improved from baseline to post-treatment on the QUEST (A, B, C, and Total), GMFM, BS Grip, and BS Bilateral Manipulation with moderate to large Cohen D effect sizes (0.40 to 0.92).

2.        TMD and MMV of the affected arm improved significantly from baseline to post-treatment (both p<0.050), in particular, during reaching and hand-to-mouth tasks.

3.        ROM during reaching tasks improved significantly in shoulder flexion, shoulder abduction/adduction and elbow flexion/extensions in the hemiparetic arm (both p<0.050, d=2.16 and d=1.52 respectively) comparable to the Control group.

4.        ROM during hand-to-mouth tasks improved significantly in shoulder and elbow joint excursion (both p<0.050).

5.        AJ improved and AS reduced from baseline to post-treatment in the hemiplegic group, but were still unable to perform at the same level as controls.