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What did the project achieve?
Children with unilateral cerebral palsy (or hemiplegia) have weakness and stiffness affecting one side of their body. Unfortunately, most children don’t have access to an adequate amount of effective therapy.
This research explored the potential benefits of a wrist-worn device that records a child’s arm movements, along with a smartphone app – to find out whether this could help encourage the use of the affected hand and arm during everyday activities for children with unilateral cerebral palsy.
“Our first step was to find the most appropriate wrist-worn device and to design child-friendly software. We held four workshops with children with hemiplegia, and their families and therapists,” says Dr Basu. “This process helped to inform our plans – leading to an approach that we hoped was fun, easy to integrate into everyday life, and have the potential to increase use of the affected arm and hand.”
The team then tested the devices and apps in a pilot study that involved 19 children with hemiplegia aged between eight and 18 years of age – and 19 friends or siblings of a similar age. Each young person wore a wristband on each arm for 10 weeks, which monitored their hand and arm movements and provided feedback about their activity levels at the end of each day. In children with hemiplegia, the wristband on the affected arm also provided a vibration prompt to boost activity at various points in the day if their movements dropped below target levels.
“Children, families and therapists found the approach acceptable and practical,” says Dr Basu. “Importantly, children with hemiplegia were prepared to wear the wristband devices for long periods. However, while activity increased in both of their arms in the hour following a prompt, these increases were not sustained.”
Families were contacted regularly during the study period for feedback and support – and families and therapists were interviewed at the end of the study to capture their views.
“Some children and families described benefits to self-esteem and performance from taking part in the study,” says Dr Basu. “Therapists also appreciated the potential for obtaining data from the app about a child’s movement to inform management strategies.”
This study showed that wearing activity trackers was feasible – and the researchers are now in a position to consider setting up a larger study of the approach, incorporating structured therapy input in addition to the wristbands and smartphone.
This research was completed on
Cerebral palsy is the most common serious physical disability in children, affecting more than 1,500 babies born in the UK each year.1,2 A common type is called hemiplegic cerebral palsy, which affects one side of a child’s body. A lack of use of their affected arm and hand can lead to irreversible weakness in adulthood. Dr Anna Basu at Newcastle University is investigating if a new approach involving a wrist-worn device and smartphone application can help boost the movement of a child’s affected limb during everyday activities. If successful, it could lead to a cheap and effective new way to help improve their chances of living a fully independent adult life.
How are children’s lives affected now?
Cerebral palsy is a lifelong condition caused by damage to the brain before, during or soon after birth. Children develop stiff muscles and bone and joint deformities that affect their movement and coordination.
Children with a form called hemiplegic cerebral palsy (or hemiplegia) have weakness and stiffness on one side of their body, with their hand and arm movements usually the most severely affected. They tend to compensate by finding ways to manage everyday tasks with their unaffected limb, neglecting their weaker hand and arm.
“But this lack of use can lead to worsening of the weakness and stiffness in their affected limb, which can have long-term consequences on their quality of life and independence,” says Dr Basu.
Encouraging a child to use their affected hand and arm regularly from an early age can help them to achieve as normal and independent a life as possible. But unfortunately, most children don’t have access to an adequate amount of effective therapy.
How could this research help?
“We are aiming to develop an effective new technology-based therapy that can be integrated into the everyday lives of children with hemiplegia,” says Dr Basu.
The team are developing a new wrist-worn device to monitor a child’s arm movement combined with a smartphone application that provides feedback to encourage them to increase activity in their weaker hand and arm.
“We are involving children, families and therapists during the design process, which we hope will help make the approach as useful, child-friendly and enjoyable as possible,” says Dr Basu.
The researchers will test the devices and apps in children with hemiplegia and their friends or siblings. They will then analyse the data and talk to the children, therapists and families to understand their experiences.
“Our results will find out if the devices are practical and acceptable – and importantly, if they help motivate children to increase use of their affected limb,” says Dr Basu. “If successful, this approach could offer an important new therapy that can help children with hemiplegia lead more independent adult lives.”
References
1.Wimalasundera, N. & Stevenson, VL., Cerebral palsy. BMJ Practical Neurology 2016; 16:184-194.
2.Office for National Statistics. Overview of the UK population: July 2017 https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigrati... [website accessed 04 Sep 2018]
| Project Leader | Dr Anna P Basu, BMBCh MA FRCPCH PhD |
| Project Team | Dr Christopher Price, MBChB MD MClinEd FRCPMrs Janice Pearse, DipCOT MPhilMrs Ruth H da Silva, BSc (Hons)Dr Jill E Cadwgan, MBChB PG Cert Clin Ed MRCPCHDr Anne L Gordon, BAppSc MSc PhDDr Yu Guan, BSc MSc PhDProfessor Tim Rapley, BA MA PhD |
| Project Location | Neurodisability Research Group, Institute of Health and Society, Newcastle University and Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne |
| Project Location Other | Stroke Research Group, Institute of Neuroscience, Newcastle UniversityNeurodevelopmental Research Group, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon TynePaediatric Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’s NHS Foundation TrustOpen Lab, School of Computing, Newcastle UniversityDepartment of Social Work, Education and Community Wellbeing, Northumbria University |
| Project duration | 18 months |
| Date awarded | 5 September 2018 |
| Project start date | 1 February 2019 |
| Project end date | 31 December 2022 |
| Grant amount | £68,563 |
| Grant code | GN2707 |
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