Assessment of bilateral motor skills and visuospatial attention in children with perinatal stroke using a robotic object hitting task.
Rachel L Hawe, Andrea M Kuczynski, Adam Kirton and 1 others
PMID 32054511WHAT IT FOUND
Children with perinatal stroke hit fewer balls than peers with both hands, especially after arterial ischemic stroke.
The unaffected hand also showed fewer hits, and attention test scores related to performance.
Key findings
01Children with both perinatal stroke types hit fewer balls than typically developing children with both hands.
02Arterial ischemic stroke showed more impairments than periventricular venous infarct, including over 80% of children with arterial ischemic stroke impaired on hits with the affected hand.
03Visuospatial attention test scores accounted for 21–32% of the variation in hits with the unaffected hand, and no child was impaired on miss bias.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
No treatment was tested, so the study cannot show that changing the task or training attention improves function. The stroke groups were small, with 28 children with arterial ischemic stroke and 21 children with periventricular venous infarct. Clinical scores were missing for 16 children (8 with arterial ischemic stroke and 8 with periventricular venous infarct), and Behavioral Inattention Test scores were missing for 2 children (1 with arterial ischemic stroke and 1 with periventricular venous infarct). Participants with severe spasticity, Manual Abilities Classification System grade V, recent upper limb surgery, botulinum toxin treatment, constraint induced movement therapy, or brain stimulation therapy were excluded, so results may not apply to more impaired children. Individual impairment flags depend on age-predicted norms created from the typically developing group. The authors note limitations of the Behavioral Inattention Test and suggest future work with eye tracking, so the mechanism behind attention-related errors is not fully established.
Declared interests
Funding was provided by the Hotchkiss Brain Institute's Robertson Fund and the Cerebral Palsy International Research Foundation. The supplied text does not report author conflict of interest declarations.
The easy way to misread this
Do not conclude that this robot task is a treatment or that attention training improves function. No intervention was tested. Do not read the absence of miss bias as proof that attention problems are absent; attention test scores still related to performance.