The use of a pressure garment for a child having ataxic cerebral palsy
Date
1996
Authors
Witoski, Mary Louise
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Abstract
An A-B-A-B single subject research design study was used to examine the effects of wearing a short-sleeved pressure garment on the quality of upper motor control for a male child six years of age having ataxic cerebral palsy. In this 10 week study four instruments were administered. At the end of each phase the Quality of Upper Extremity Skills Test (DeMatteo, Law, Russell, Pollock, Rosenbaum & Walter, 1992) was administered to the child for a total of four assessments. Across each phase five functional items, such as Stacking Cubes and Inserting Pegs were administered to the child for a total of 30 sessions. The 30 sessions were used to evaluate the child's level of goal attainment (GAS) and the frequency of occurrence of atypical motor characteristics (AMCS). Supplementary information including specific daily activities were easy or difficult to perform wearing the garment were collected using Parent / Child Observation Logs.
When the child was wearing the garment the QUEST Summary Scores for Grasps and Protective Extension and the QUEST Total Scores yielded significant increases in the child's quality of upper motor control. The child's GAS changes in mean scores indicated that only Stacking Cubes yielded significant changes in the child's level of goal attainment. The child's AMCS changes in percentage scores showed that only Stacking Cubes yielded significant decreases in the frequency of occurrence of atypical motor characteristics. However by the end of the study all of the functional items except Inserting Pegs suggested significant increases in percentage scores. Visual inspection across the child's functional items' suggested AMCS characteristics that involved precise motor actions, such as grasping and reaching showed the greatest decreased frequency of occurrence. Using the same instrument, the child's results of Walk-a-Line indicated there were no significant changes in the frequency of occurrence. When the child was wearing the garment the Parent / Child Observation Logs narrative comments suggested the child was willing to try more fine motor activities. However the impact the garment had on specific daily activities was inconclusive due to scoring procedural difficulties. The findings and recommendations of this study provide additional support to further investigate the therapeutic use of pressure garment with this population and other individuals having motor incoordination difficulties.