Cognitive approach to rehabilitation in children with hyperkinetic movement disorders post-DBS.

Neurology
Hortensia GimenoHelene J Polatajko

Abstract

This proof-of-concept feasibility trial examined the potential of the Cognitive Orientation to daily Occupational Performance Approach (CO-OP) to augment deep brain stimulation (DBS) outcomes in childhood-onset hyperkinetic movement disorders (HMD) including dystonia and dyskinetic cerebral palsy. This is a single case experimental design using multiple baseline as n-of-1 trial comprising 10 intervention sessions, with replications across participants (n = 10). Treatment focused on 3 participant-selected goals. Transfer was assessed on 2 additional untreated goals. Individuals enrolled were 6-21 years of age and had DBS in situ and sufficient manual ability. Primary outcome was functional performance change on the Performance Quality Rating Scale-Individualized (PQRS-i) measured before, during, and posttreatment, and at 3-month follow-up. Assessors of outcome were blinded to time of assessment, number of intervention session, and treatment allocation. To measure effect size, a nonoverlapping index, Tau-U, was used. Feasibility measures were captured. One participant withdrew before baseline assessment. Effect sizes of at least 0.66 were seen at both posttreatment and follow-up with all participants showing improvements in at le...Continue Reading

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References

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Mar 7, 2012·The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association·Helene J PolatajkoCarolyn M Baum
Feb 19, 2014·Neuropsychological Rehabilitation·Hariharan SwaminathanKeith Smolkowski
Feb 11, 2015·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Daniel E LumsdenJean-Pierre Lin
Jun 11, 2016·Physical & Occupational Therapy in Pediatrics·Debra CameronHelene J Polatajko
Jun 16, 2016·Lancet Neurology·Anne KoyLars Timmermann
Oct 7, 2016·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Hortensia Gimeno, Jean-Pierre Lin

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