Adaptive Arm Training for Children With Hemiplegia

The goal of this research is to provide limb training in children with hemiplegia using a bimanual-to-unimanual training approach. Twenty pediatric patients aged 5-17 years with acquired brain injury will receive training on the bimanual-to-unimanual device for a period of 9 weeks. During the training, children use both arms to operate robotic arms to play a video game. We will assess changes in hand impairment after the training.

Children in the study will all receive the same treatment, which includes 9 weeks of training on the bimanual arm trainer robotic device.

Device-based bimanual-to-unimanual training will be provided with the Bimanual Arm Trainer (BAT, Mirrored Motion Works, NC). The device provides bimanual-to-unimanual training of simultaneous shoulder external rotation and elbow extension, and independent training of pronation-supination and grasp and release of each hand. Range of motion and speed are recorded during training and feedback and motivation are provided through age-appropriate gaming modules.

The Assisting Hand Assessment evaluated how effectively children use their hands to complete bimanual tasks.

The Box and Blocks test measures how many blocks a child can move with one hand from one box to another in one minute with the impaired hand.

Inclusion Criteria: Hemiplegia due to brain injury at least 3 months before study enrollment. Exclusion Criteria: Any social or medical problem that precludes compliance with the protocol. Treatment with botulinum toxin or intrathecal baclofen in the 3 months preceding enrollment. Implanted neuromodulatory or electronic device or other complicating illness.

We plan to share results with our collaborator Dr. Preeti Raghaven, at New York University. Dr. Raghavan created the robot we are using, has IRB approval to use the robot, and is a consultant on this study. Personal health information will not be shared.