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Cerebral Palsy News

Kids with Cerebral Palsy May See Improvement in Hand Function Using Nintendo Wii

June 13, 2016 BY ÖZGE ÖZKAYA, PHD

A new study conducted by Turkish scientists suggests the Nintendo Wii game system could improve hand function of children with cerebral palsy when combined with neurodevelopmental treatment. This suggests that Wii could be used to offer a motivational, safe, and enjoyable rehabilitation program alongside neurodevelopmental therapy.

“Since the Nintendo Wii increases motivation and provides an opportunity for enjoyable therapy, we think that it increases adaptation of children to rehabilitation programs and that it may be added to conventional treatment programs,” wrote the authors in their article, “Efficacy of neurodevelopmental treatment combined with the Nintendo Wii in patients with cerebral palsy,” and published in the Journal of Physical Therapy Science.

The research involved 30 children ages 6 to 15 with cerebral palsy. The children were divided into two groups: One group received 45 minutes of neurodevelopmental treatment only, while the other received the same amount of neurodevelopmental treatment and played three different games of virtual tennis, baseball, and boxing for five minutes each. This program was repeated twice a week over six weeks. The research team looked at the ability of the children to use their arms and hands, and assessed their functional independence.

The results showed that after six weeks of treatment, the hand function, speed, and ability in all children had improved compared to the beginning of the study. When the two groups of children were compared, the researchers saw that children who played the Wii games combined with neurodevelopmental treatment scored significantly higher in tests measuring hand function.

Researchers concluded that Nintendo Wii games may have beneficial effects on hand function and independence levels in daily life activities in children with cerebral palsy when combined with neurodevelopmental therapy.

Cerebral palsy is the most common cause of neurological disability in children. It affects around one in 1,300 live births, and is caused by damage to the brain or nervous system. Wrists and hands are sometimes affected, making it difficult to fulfil daily tasks.
Neurodevelopmental treatment is widely used in children with cerebral palsy to enhance motor function. It has been shown to improve gross motor function, as well as hand function. However, motivation can sometimes be a problem. The use of virtual gaming devices such as Nintendo Wii has been suggested to be a motivating and fun way to treat children with cerebral palsy.

Not a cure, but closure: new cerebral palsy research gives families hope…
KATE SHERIDAN, MONTREAL GAZETTE, Published on: August 3, 2015www. http://montrealgazette.com/

Four-year-old Bennett Ross has a bright smile as he sits on his mother’s lap, looking around the kitchen.

“He’s just like every other four-year-old,” said his mother, Emily Diamond, with one major difference — Bennett is one of the 140 children diagnosed each year in Quebec with cerebral palsy, the most common cause of physical disability in children. Many cases of cerebral palsy, like Bennett’s, are caused by damage to the brain during pregnancy or birth. But for some, there is no obvious explanation. However, a Canadian study published Monday in Nature Communications journal may open the door to genetic testing for cerebral palsy and shed light on the prevention and treatment of the condition. Parents want to know why their children have CP, said neurologist and study co-author Maryam Oskoui, one of Bennett’s doctors at the Montreal Children’s Hospital of the McGill University Health Centre. “It’s a diagnosis that changes the child’s life, it changes the family’s life and functioning. It’s a natural instinct to try to find a cause,” said Oskoui, also co-director of the Canadian Cerebral Palsy Registry. Until recently doctors were told that genetic testing should not be done for children suspected of having CP. Doctors believed that CP wasn’t a genetic disease — it happened because of something in the mother’s environment. But “this study will change that,” said Stephen Scherer, one of the senior authors of the paper and a scientist at The Hospital for SickKids in Toronto. Oskoui and her colleagues tested 115 children from the registry and found 10 per cent had genetic alterations. The study found “copy number variants (CNVs)”, which are DNA structural changes, in the genomes of the children and their parents. Scherer said the size of the CNVs and the fact that the changes haven’t been linked to other diseases or to the children’s parents indicated that the changes could be linked to CP.

If genetic testing becomes the standard of care for children with CP, it might also affect the treatment. Based on the research, at least one of the children would have been diagnosed with a different disorder, Scherer said. “Had we had the genetic finding, we would have known right away that he had Angelman syndrome,” which can mimic CP, but requires different therapy and medical specialists, he said. According to Oskoui, children with Angelman syndrome are at an even higher risk for epilepsy. The study suggests many different genes were affected by the CNVs, but only one has been previously linked to CP. “Using the approach we used, we have not pinpointed any other genes that could be used on their own in a diagnostic setting,” Scherer said, but he emphasized that the large-scale change in the chromosomes is a risk factor for CP.

The research is also a starting point for more research. “We’re doing whole-genome sequencing in all these samples now,” Scherer said. “We’ll get to the underlying genes.” “We say cerebral palsy is never the same disease twice, because of the different causes but also because of the different phenotypes,” Oskoui explained. “We have some children that are not able to walk by themselves and have to be in a wheelchair, like Bennett, and there are other children who are able to walk, but they walk a little differently or they need some extra support. Some children are able to understand everything very well, but they’re not able to speak.” Bennett has difficulty controlling his movements and will probably never speak, but his cognitive abilities aren’t heavily affected. “He is all there, he just can’t tell you in normal words.” Diamond explained. Through therapy at Mackay Rehabilitation Centre, Bennett has learned how to tell people “yes” and “no” by looking at bracelets, one on each of his arms, corresponding to a word. He’s also been improving his control over some of his movements; he held a crayon and drew with it for the first time just a few months ago, Diamond said. Bennett will continue his therapy and go to school at Mackay. “He loves the building, he loves being there.

I think that will make the transition a bit easier,” said Diamond. “I honestly don’t know where we’d be without them.” Diamond said that Bennett’s CP isn’t due to genetic factors — it’s because of something that happened while she was pregnant. While she was pregnant with Bennett, Diamond’s husband, Tim Ross, found her lying unconscious on the floor because of an internal bleed. She needed emergency surgery to repair a ruptured vein in her abdomen on Christmas Eve. Bennett was diagnosed with CP six months after he was born. “The doctors said (Bennett’s) brain was without oxygen for one or two seconds,” she said. “One or two seconds. It’s a blink.” Diamond said that she thought it would have been even scarier if she hadn’t had something to pinpoint as a cause for Bennett’s condition, so she hopes Oskoui and Scherer’s research gives parents a bit of closure. “I think this will be really helpful to parents,” she said, “to let them know that you didn’t do anything wrong, there’s nothing you could have changed, it was there.”
“Even though there is no reason — there’s a reason.”