title: Home based computer-assisted upper limb exercise for young children with cerebral palsy: a feasibility study investigating impact on motor control and functional outcome.
abstract: OBJECTIVE
  We developed a home-based rehabilitation exercise system incorporating a powered joystick linked to a computer game, to enable children with arm paresis to participate in independent home exercise. We investigated the feasibility and impact of using the system in the home setting.
  
  
  METHODS
  Eighteen children with cerebral palsy (median age 7.5 years, age range 5-16 years) were recruited from local National Health Service and the exercise system was installed in their home for approximately 4 weeks. Baseline and post-intervention assessments were taken: Canadian Occupational Performance Measure (COPM); kinematic measurement of movement quality (indexed by duration and smoothness) measured using a motion tracking system when performing a standardized computer task.
  
  
  RESULTS
  The system was used for a median time of 75 min (interquartile range (IQR) 17-271), equating to 606 outward and 734 inward movements. Pre-COPM, (median 4.2); post-COPM (median 6.0); obs=34; z=3.62, p<0.01). Kinematic analysis of pre- and post-intervention movements on the standardized task showed decreased duration and increased smoothness.
  
  
  CONCLUSIONS
  Some improvements in self-reported function and quality of movement are observed. This pilot study suggests that the system could be used to augment home-based arm exercise in an engaging way for children with cerebral palsy, although a controlled clinical trial is required to establish clinical efficacy. The feasibility of this technology has been demonstrated.
authors.affiliation: School of Mechanical Engineering, The University of Leeds, Leeds, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Weightman
authors.forename: Nick
authors.initials: N
authors.lastname: Preston
authors.forename: Martin
authors.initials: M
authors.lastname: Levesley
authors.forename: Raymond
authors.initials: R
authors.lastname: Holt
authors.forename: Mark
authors.initials: M
authors.lastname: Mon-Williams
authors.forename: Mike
authors.initials: M
authors.lastname: Clarke
authors.forename: Alastair J
authors.initials: AJ
authors.lastname: Cozens
authors.forename: Bipin
authors.initials: B
authors.lastname: Bhakta
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D015397:Program Evaluation; D012371:Robotics; D012648:Self Care; D012984:Software; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D014584:User-Computer Interface