title: Conductive education for children with cerebral palsy: effects on hand motor functions relevant to activities of daily living.
abstract: OBJECTIVE
  To study the effects of conductive education, a combined educational and therapeutic task-oriented approach for children with cerebral palsy (CP), on their hand motor functions and activities of daily living (ADLs).
  
  
  METHODS
  Individual cohort study (B-A-B design).
  
  
  METHODS
  Ambulatory, referral center.
  
  
  METHODS
  Sixty-four children with CP, severity Gross Motor Function Classification System levels II through IV, ages 3 to 6 years.
  
  
  METHODS
  Phases B: a 4.5-month period of special education, including 2 hours of individual physiotherapy or occupational therapy per week (special education). Phase A: during a 9-month period, conductive education was administered in 3 blocks of 4 weeks (7 hours daily from Monday through Friday); between the blocks, special education was applied as in the B phases.
  
  
  METHODS
  Transformed sum scores (0.00-1.00) for coordinative (eg, force-movement synergy during object manipulation, aiming) and for elementary hand functions (eg, maximum grip force, tapping), based on kinetic and kinematic measures; standardized parent questionnaire to measure ADL competence scores from 0.00 (dependence) to 1.00 (independence). Outcome parameters were changes in these parameters during phase A (intervention) compared with average changes during the B phases (pre- and postintervention). Student t tests were used for dependent samples.
  
  
  RESULTS
  Conductive education improved coordinative hand functions by 20% to 25% from baseline, compared with no improvement during special education; the preferred hand improved from .38 to .48 (mean, .10; 95% confidence interval [CI], .086-.114) and the nonpreferred hand improved from .39 to .47 (mean, .08; 95% CI, .034-.116). There were no changes in elementary hand motor functions. ADL competence improved by .11 (95% CI, .070-.149), from .50 to .61 ( approximately 20%), compared with no significant improvement under special education.
  
  
  CONCLUSIONS
  Conductive education improved coordinative hand functions and ADLs in children with CP. There was no effect on elementary hand functions.
authors.affiliation: Institute of Social Pediatrics and Adolescent Medicine, Child Center Munich, Ludwig Maximilians University, Munich, Germany. rjblank@gmx.de
authors.forename: Rainer
authors.initials: R
authors.lastname: Blank
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Stefan
authors.initials: S
authors.lastname: Hesse
authors.forename: Hubertus
authors.initials: H
authors.lastname: von Voss
mesh_terms: D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000193:education / Q000534:rehabilitation*; D004519:Education, Special / Q000379:methods*; D005260:Female; D006225:Hand / Q000502:physiology*; D006801:Humans; D008297:Male; D009048:Motor Skills; D009788:Occupational Therapy / Q000379:methods; D026741:Physical Therapy Modalities; D016896:Treatment Outcome