Pediatric Hand Grasp

Overview

It is estimated that a third of the almost 800,000 Americans with cerebral palsy have hemiplegia, which results in disuse of the weaker hand in everyday life from childhood on with very few effective treatments. Recent research has shown that interventions that facilitate repetitive goal-oriented motion of the paretic limb, such as constraint-induced movement therapy and bimanual intensive therapy, may facilitate cortical change and improved hand function in hemiparetic CP. However, these emerging therapies require some residual movement and therefore are not applicable to those who do not have sufficient hand movement for functional task practice.

There is a lack of effective interventions for the hundreds of thousands of children who face life-long hand disability due to cerebral palsy. This program is an important initial step in the development of a new therapy combining that is applicable to a wide range of children with cerebral palsy, including those with severe degrees of hand disability. The program’s significance to public health is to contribute to an unmet need for increased understanding of motor learning mechanisms and development of clinically viable techniques for treating congenital and developmental disabilities.
 

Virtual Environments Integrated with FES for Hemiplegia

This program will assess a new therapy for improving hand function in children with hemiplegic cerebral palsy utilizing an innovative neuromuscular electrical stimulation therapy that incorporates several rehabilitation techniques shown to improve recovery. Contralaterally Controlled Functional Electrical Stimulation (CCFES) activates paretic muscles to open and close the affected hand in direct proportion to the degree of opening and closing of the unimpaired contralateral hand, as detected by a sensor glove. CCFES will be used in combination with hand therapy video games.

The six-week treatment consists of daily video game therapy at home and functional task practice sessions in the lab twice a week for the first 3 weeks and once per week for the final 3 weeks. Outcome measures will include assessments of upper extremity motor impairment and activity limitation using clinical assessments, along with instrumented assessments. The clinical measures will help power larger future clinical trials, while the instrumented assessments directly examine motor dysfunctions targeted by CCFES and will begin to reveal neural circuits and behaviors that can influence CCFES-mediated motor learning in hemiplegic CP.
 

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Principal Investigator: Michael Fu, PhD
Contact Number: (216) 957-3597
Contact Email: mjf24@case.edu