We have recently produced a website with free downloadable ideas for fun activities for children age 3-10 years with hemiplegia which encourage children to use both hands together in play. These suggestions are many of the activities which were used in our play-based therapy trial described below. The activities are targeted at families but are searchable by therapy goal so as to be of maximal use to therapists as well.
The instructions were developed by Emma Kirkpatrick whilst undertaking a PhD at the Institute of Neuroscience, Newcastle University, supervised by Dr Anna Basu and with advice from senior paediatric occupational therapist Janice Pearse. The project was funded by WellChild and by a Henry Miller studentship from Newcastle University. The instructions were made as part of a trial comparing two forms of play-based therapy to improve upper limb function in children with hemiplegia age 3-10 years:
Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial by Emma Kirkpatrick, Janice Pearse, Peter James and Anna Basu
In this study we looked at a brain network called the “mirror neuron system”. You activate this when moving but also when watching the same movement performed by others. We know that careful watching and copying are an important way of learning new activities. We wanted to see whether adding “watching and copying” into therapy would improve hand function more than repeated practice of movements alone. We also wanted to develop a play-based therapy that parents/carers could use at home.
What did we do?
We developed a series of play activities useful for children with hemiplegia. For each game or toy, one set of instructions focused on watching and copying a parent’s moves. The other set focused on repeated independent practice, with the parent supporting rather than repeating the activity.
70 children aged 3 to 10 years took part in the trial in two random groups. Everyone followed a therapy programme for 3 months. This consisted of 15 minute sessions, 5 days a week. All children completed the same range of assessments.
What did we find?
At 3 months, there was no difference in the improvement of hand function between the two groups. However, both groups improved significantly on all three outcome measures (Assisting Hand Assessment (AHA), Melbourne Assessment of Unilateral Upper Limb Function - 2 (MA2), Abilhand-KIDS).
What does it mean?
Watching movements before copying them does not seem to create better results than repeated practice if done at home with parents. However, play activities with parents, which focus on particular hand movements, do lead to small but significant improvements in hand function.
How can I find out more?
Read our open access research article here:http://onlinelibrary.wiley.com/doi/10.1111/dmcn.13109/full
Kirkpatrick, E., Pearse, J., James, P. and Basu, A. (2016), Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial. Dev Med Child Neurol, 58: 1049–1056. doi:10.1111/dmcn.13109
What does the Fun ‘n’ Games website include?
We wanted to make the materials used for home-based therapy in the trial freely and widely available, and this is why we developed the website. The full website contents are:
- Home page with a quick overview
- Background explaining the rationale for developing the website, including a link to the open access publication of the trial
- Instructions/advice for optimal seating when working on hand function
- A link to the downloadable pdfs, accessed after completion of a form providing some details regarding the person requesting access
- A glossary covering helpful terminology, with illustrative videos
- Useful links to other relevant websites
- A page providing some information about the team
Twitter: @FUNnGames4HCP
We hope you find the materials useful!