Motor learning characterizes habilitation of children with hemiplegic cerebral palsy

  • Krebs H
  • Fasoli S
  • Dipietro L
 et al. 
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BACKGROUND: This study tested in children with cerebral palsy (CP) whether motor habilitation resembles motor learning.

METHODS: Twelve children with hemiplegic CP ages 5 to 12 years with moderate to severe motor impairments underwent a 16-session robot-mediated planar therapy program to improve upper limb reach, with a focus on shoulder and elbow movements. Participants were trained to execute point-to-point movements (with robot assistance) with the affected arm and were evaluated (without robot assistance) in trained (point-to-point) and untrained (circle-drawing) conditions. Outcomes were measured at baseline, midpoint, immediately after the program, and 1 month postcompletion. Outcome measures were the Fugl-Meyer (FM), Quality of Upper Extremity Skills Test (QUEST), and Modified Ashworth Scale (MAS) scores; parent questionnaire; and robot-based kinematic metrics. To assess whether learning best characterizes motor habilitation in CP, the authors quantified (a) improvement on trained tasks at completion of training (acquisition) and 1 month following completion (retention) and (b) quantified generalization of improvement to untrained tasks.

RESULTS: After robotic intervention, the authors found significant gains in the FM, QUEST, and parent questionnaire. Robot-based evaluations demonstrated significant improvement in trained movements and that improvement was sustained at follow-up. Furthermore, children improved their performance in untrained movements indicating generalization.

CONCLUSIONS: Motor habilitation in CP exhibits some traits of motor learning. Optimal treatment may not require an extensive repertoire of tasks but rather a select set to promote generalization.

Author-supplied keywords

  • cerebral palsy
  • kinematics
  • motor learning
  • rehabilitation robotics
  • robot-mediated therapy

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