title: Can new technologies improve upper limb performance in grown-up diplegic children?
abstract: BACKGROUND
  Few systematic studies describe rehabilitation trainings for upper limb in diplegic children with cerebral palsy (CP), who - especially once grown up - are often not considered as a target for rehabilitation interventions.
  
  
  OBJECTIVE
  In this pilot study, we describe the details and the effectiveness of an intensive, technology assisted intervention for upper limb.
  
  
  METHODS
  The treatment combines the utilization of Armeo® Spring with a training focused on hand/finger fluency and dexterity in a pre-post treatment experimental design.
  
  
  METHODS
  Participants were ten school-aged children (mean age 11.2) with bilateral CP and diplegia, attending mainstream schools.
  
  
  METHODS
  Participants underwent 40 therapy sessions in four weeks. Armeo® Spring measures, standardized motor and perceptual outcome indexes, as well as everyday life indicators were utilized to assess the effect of the intervention.
  
  
  RESULTS
  Upper limb coordination, fluency and quality of movements mainly of hands and fingers significantly improved, with a good transferability to everyday life also in areas not specifically trained, such as self-care abilities and mobility. Probably due to the visual feedback provided by the virtual reality setting (which was all in one the context, the incentive and the product of activities), perceptual abilities significantly improved, too.
  
  
  CONCLUSIONS
  Our study suggests the importance of intervention on upper limb even in milder CP diplegic forms and in relatively grown-up children. The possibility of modification at least partially relies on learning processes that are active all along development and benefit from stimulation.
  
  
  CONCLUSIONS
  Though further studies with control groups and follow-up perspective are needed to confirm, new technologies offer interesting possibilities to be integrated into new evidence-based rehabilitation models.
authors.affiliation: Eugenio Medea Institute for Scientific Research, Bosisio Parini, Lecco, Italy - chiara.gagliardi@bp.lnf.it.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Turconi
authors.forename: Emilia
authors.initials: E
authors.lastname: Biffi
authors.forename: Cristina
authors.initials: C
authors.lastname: Maghini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Peri
authors.forename: Fernanda
authors.initials: F
authors.lastname: Servodio Iammarone
authors.forename: Chiara
authors.initials: C
authors.lastname: Gagliardi
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000367:Age Factors; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000534:rehabilitation*; D002648:Child; D005081:Exercise Therapy / Q000379:methods / Q000639:trends*; D005260:Female; D005544:Forecasting; D006801:Humans; D007558:Italy; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D026201:Musculoskeletal Manipulations / Q000379:methods / Q000639:trends; D010865:Pilot Projects; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D012648:Self Care; D012720:Severity of Illness Index; D012737:Sex Factors; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*