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Table 4.3 Interventions for Fine Motor Rehabilitation Post ABI

by | Dec 5, 2018

Table 4.3 Interventions for Fine Motor Rehabilitation Post ABI

Author, Year Country Study Design Sample Size Methods Outcome
Neistadt (1994) USA RCT PEDro=5 N=45   Population: TBI=42, Anoxia=3; Mean Age=33.2yr; Gender: Male=45, Female=0, Mean Time Post Injury=7.9yr. Intervention: Participants were assigned to either the parquetry block assembly (n=22) or the meal preparation group (n=23). Subjects received individual training sessions (3, 30 min sessions for 6wk) in addition to their regular program. Outcome Measure: WAIS-R (Block Design Test), Parquetry Block Test, RKE-R, and Jebsen-Taylor Test of Hand Function. 1.       For picking up small objects with the dominant hand, the meal preparation group showed a significantly greater improvement over the puzzle group (p=0.027). 2.       There was no significant difference in improvement between the two groups for simulated page turning with dominant hand (p=0.655), simulated page turning with the non-dominant hand (p=0.182) and picking up small objects with the non-dominant hand (p=0.265).
Korman et al. (2018) Belgium PCT N=20 Population: Experimental Group (N=10): Mean age=30yr; Mean time post-injury=126.9d; GCS range: 3-12. Control Group (N=10): Mean age=29.3yr; Mean time post-injury=118.4d; GCS range: 3-8. Intervention: Individuals were either trained or not trained to complete a 5-finger sequence task. Training took place every day for five days, with approximately 100 sequence repetitions in each practice. Assessment occurred pre-intervention, post-intervention, and at 1-month follow-up. Outcome Measures: Number of correct and incorrect completed sequences during testing. 1.        There were no significant differences between groups in performance on the sequence task before the intervention occurred. 2.        The trained group showed a significant improvement over the course of training for performance speed (p<0.001), as did the control group (p<0.001). 3.        There were no significant differences in the number of errors produces before the intervention compared to post-intervention for either group. 4.        The trained group had significantly greater spontaneous gains over the course of the study (p=0.016). Within session gains became negative over the course of the week with performance degrading closer to the end of training sessions (p<0.05). Between session gains steadily improved over the course of training (p<0.05).
        Yungher & Craelius (2012) USA PCT N=19 Population: TBI=8, Stroke=4, Healthy Subjects=7; Experimental Group (n=12): Mean Age=39.8yr; Gender: male=8, female=4. Healthy Control Group (n=7): Mean Age=46.4yr. Intervention: The use of Gesture Recognition Biofeedback (GRB), which uses surface muscle pressures of the forearm to provide real-time visual biofeedback, was compared to standard repetitive training without feedback. Measures were completed before and after each condition. Outcome Measure: Nine-Hole Peg Test (HPT). 1.        HPT scores for the experimental group ranged from 28.6 to 263 sec, and 15.78 to 25.56 sec for the control group. 2.        For those with impairments (n=12), in training with feedback there was an average decrease in HPT time to completion of 15.5%, and with no feedback there was an increase in time by 2.07%. 3.        For those with impairments, GRB training resulted in an improvement of 27.3% (p<0.05), without the GRB training there was a 2.07% decline in performance. 4.        In the controls, GRB training has minimal effect. The time to completion was faster in this group, compared to the impaired group, at baseline, and with and without feedback (p<0.05).
Kriz et al. (1995) Germany Pre-Post N=27   Population: TBI=3, Stroke=2, Intracerebral bleeding=3, Viral Encephalitis=1, Cerebral Abscess=1, Healthy Controls=17. Gender: Male=17. Female=10; Impaired Group (n=10): Mean Age=33.8yr; Mean Time Post Injury=14.7mo. Healthy Control group (n=17): Age Range=22-42yr. Intervention: Patients completed a feedback-based training intervention that involved tracking moving targets with grip force, using a precision grip. Patients trained over 10 weekly 30 min sessions. Training terminated when normal performance was achieved. Outcome Measure: Force control using grip strength, Tracking errors, and Transfers. 1.       No significant change in control subject’s performance (p>0.10). Nine of 10 participants with impairments reduced tracking errors significantly (p<0.05) and improved in transfer tasks (p<0.05). 2.       Impaired initial performance and improvement was not uniform and could be attributed to individual aspects of force control.