A Pilot Feasibility Study on the Use of Dual-Joystick-Operated Ride-on Toys in Upper Extremity Rehabilitation for Children with Unilateral Cerebral Palsy

Sudha Srinivasan; Patrick D Kumavor; Kristin Morgan

doi:10.3390/children11040408

A Pilot Feasibility Study on the Use of Dual-Joystick-Operated Ride-on Toys in Upper Extremity Rehabilitation for Children with Unilateral Cerebral Palsy

Children (Basel). 2024 Mar 29;11(4):408. doi: 10.3390/children11040408.

Authors

Sudha Srinivasan^{1

2

3}, Patrick D Kumavor⁴, Kristin Morgan⁴

Affiliations

¹ Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
² Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT 06269, USA.
³ The Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT 06269, USA.
⁴ Biomedical Engineering Department, University of Connecticut, Storrs, CT 06269, USA.

Abstract

Children with unilateral cerebral palsy (UCP) require task-oriented practice several hours per week to produce meaningful gains in affected upper extremity (UE) motor function. Clinicians find it challenging to provide services at the required intensity and sustain child engagement. This pilot study assessed the acceptance and utility of a child-friendly program using dual-joystick-operated ride-on toys incorporated into an intensive UE rehabilitation camp. Eleven children with UCP between four and 10 years received ride-on-toy navigation training for 20-30 min/day, five days/week, for three weeks as part of camp programming. We report session adherence and percent time children spent in task-appropriate attention/engagement across sessions. The overall effects of camp programming on children's motor function were assessed using the Shriner's Hospital Upper Extremity Evaluation (SHUEE) from pretest to posttest and using training-specific measures of bimanual UE use and navigational accuracy. Children showed excellent adherence and sustained task-appropriate engagement across sessions. The combined program led to improved navigational accuracy (p-values ≤ 0.007) as well as spontaneous affected UE use during bimanual activities outside the training context (p < 0.001). Our pilot study provides promising evidence for using modified, commercially available ride-on toys to incentivize rehabilitation and boost repetitive, task-oriented UE practice among children with UCP.

Keywords: bimanual training; constraint-induced movement therapy; engagement; feasibility study; joystick-operated ride-on toys; rehabilitation; technology-based aids; therapy adjunct; unilateral cerebral palsy; upper extremity.

Grants and funding

This research received no external funding. The study-related costs were covered through start-up funds provided to the corresponding author by the University of Connecticut. The APC was funded by a scholarship facilitation fund to the corresponding author through the Office of the Vice President for Research (OVPR) at the University of Connecticut and through start-up funds provided to the corresponding author by the University of Connecticut.