Journal of Modern Rehabilitation 2016. 10(2):86-92.

Effect of Sensory Interventions on Motor Function of Upper Limb in 8-12 Years Old Children with Spastic Hemiplegia
Moloud Khoshbakht, Parvin Raji, Noureddin Nakhostin Ansari, Mahmoud Mahmodian


Introduction: Spastic hemiplegia is one of the most common types of cerebral palsy. Pathology of the central nervous system can alter normal development of the somatosensory cortex and develop sensory deficits. These deficits can decrease upper limp motor performances and skills and reduce the tendency to use the affected upper limp, so the quality of life is impaired in these children. Therefore, in this study, the effect of sensory interventions (as part of occupational therapy services that impact on the performance of these children have been less reported) on motor function of affected upper limb children with spastic hemiplegia
was investigated.
Material and Methods: In this study, three children with spastic hemiplegia participated using single-subject (A-B) design. During the baseline phase, motor function was measured by Box and Block for three sessions a week to record changes pattern. After an initial assessment, treatment phase began. In this phase, children received sensory training interventions in 12 sessions and 3 times a week. Treatment program was included two parts: tactile and proprioceptive stimulation as active, passive and playfulness. Training for each child was provided according to his/her condition and was graded so that progress, activities got more difficult with the child’s progress. At the end of each week, evaluation was done to record regularly changes after the treatment phase. As follow-up, children were evaluated in three sessions, every other day. Then results of 3 phases were analyzed.
Results: In a visual analysis for each three children, slope in both treatment and baseline phases was accelerating but in treatment was more than baseline. The effect size was large in all of them. In 2SD method, the results of second and third subjects were approved. However, it was not significant for the first one.
Conclusion: Sensory interventions as training program based on sensory deficits can be effective in upper limb motor function in spastic hemiplegia.


Sensory intervention; Motor function; Cerebral palsy; Spastic hemiplegia

Full Text:



Papavasiliou AS. Management of motor problems in cerebral palsy: a critical update for the clinician. Eur J Paediatr Neurol 2009; 13(5): 387-96.

Herskind A, Greisen G, Nielsen JB. Early identification and intervention in cerebral palsy. Dev Med Child Neurol 2015; 57(1): 29-36.

Sakzewski L, Ziviani J, Boyd R. Systematic review and meta-analysis of therapeutic management of upper-limb dysfunction in children with congenital hemiplegia. Pediatrics 2009; 123(6): e1111-e1122.

Krageloh-Mann I, Cans C. Cerebral palsy update. Brain Dev 2009; 31(7): 537-44.

Houwink A, Aarts PB, Geurts AC, Steenbergen B. A neurocognitive perspective on developmental disregard in children with hemiplegic cerebral palsy. Res Dev Disabil 2011; 32(6): 2157-63.

Gharebaghi S, Hadian M R, Abdolvahab M, Dehghan L, Raji P, Faghih Zadeh S. The effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic cerebral palsy, 3-7 years old. J Mod Rehabil 2010; 4(3-4): 53-7. [In Persian].

Akbari H. The examination of spherical grasp and Tripod Pinch strength in 4-6 years old children of Tehran kindergarten [Thesis]. Tehran, Iran: Tehran University of Medical Science; 1996. 2016.

Chen YP, Kang LJ, Chuang TY, Doong JL, Lee SJ, Tsai MW, et al. Use of virtual reality to improve upper-extremity control in children with cerebral palsy: a single-subject design. Phys Ther 2007; 87(11): 1441-57.

Wingert JR, Burton H, Sinclair RJ, Brunstrom JE, Damiano DL. Tactile sensory abilities in cerebral palsy: deficits in roughness and object discrimination. Dev Med Child Neurol 2008; 50(11): 832-8.

Majnemer A, Bourbonnais D, Frak V. The role of sensation for hand function in children with cerebral palsy. In: Eliasson AC, Burtner PA, Editors. Improving hand function in cerebral palsy: theory, evidence and intervention.London, UK: Mac Keith Press; 2009.

Taranto SR. Reliability and validity of the HASTe in assessing bilateral sensory function in children with hemiplegia [MSc Thesis]. Columbus, OH: Ohio State University. 2012.

Robert MT, Guberek R, Sveistrup H, Levin MF. Motor learning in children with hemiplegic cerebral palsy and the role of sensation in shortterm motor training of goal-directed reaching. Dev Med Child Neurol 2013; 55(12): 1121-8.

Auld ML, Boyd RN, Moseley GL, Ware RS, Johnston LM. Impact of tactile dysfunction on upper-limb motor performance in children with unilateral cerebral palsy. Arch Phys Med Rehabil 2012; 93(4): 696-702.

Dickerson AE, Brown LE. Pediatric constraintinduced movement therapy in a young child with minimal active arm movement. Am J Occup Ther 2007; 61(5): 563-73.

Barrett ML, Jones MH. The 'sensory story'. A multi-sensory training procedure for toddlers. 1. Effect on motor function of hemiplegic hand in cerebral palsied children. Dev Med Child Neurol 1967; 9(4): 448-56.

Riyahi A, Rassafiani M, Akbarfahimi N, Karimloo M. Test-retest and inter-rater reliabilities of the of Manual Ability Classification System (MACS)- Farsi version in children with cerebral palsy. J Res Rehabil Sci 2012; 8(2): 203-11. [In Persian].

Karami A. Child intelligence measurement: Raven children's Test. Tehran, Iran: Ravansanji Publication; 2012. p. 7-10. [In Persian].

Wagner LV, Davids JR. Assessment tools and classification systems used for the upper extremity in children with cerebral palsy. Clin Orthop Relat Res 2012; 470(5): 1257-71.

Nourbakhsh MR, Ottenbacher KJ. The statistical analysis of single-subject data: a comparative examination. Phys Ther 1994; 74(8): 768-76.

Auld ML, Russo R, Moseley GL, Johnston LM. Determination of interventions for upper extremity tactile impairment in children with cerebral palsy: a systematic review. Dev Med Child Neurol 2014; 56(9): 815-32.

Smania N, Montagnana B, Faccioli S, Fiaschi A, Aglioti SM. Rehabilitation of somatic sensation and related deficit of motor control in patients with pure sensory stroke. Arch Phys Med Rehabil 2003; 84(11): 1692-702.

Byl N, Roderick J, Mohamed O, Hanny M, Kotler J, Smith A, et al. Effectiveness of sensory and motor rehabilitation of the upper limb following the principles of neuroplasticity: patients stable poststroke. Neurorehabil Neural Repair 2003; 17(3): 176-91.

Carr JH, Shepherd RB. Stroke rehabilitation: guidelines for exercise and training to optimize motor skill. Oxford, UK: Butterworth-Heinemann; 2003.

Cohen HS. Neuroscience for rehabilitation. Philadelphia, PA: Lippincott Williams & Wilkins; 1999.

Asanuma H. Functional role of sensory inputs to the motor cortex. Prog Neurobiol 1981; 16(3-4): 241-62.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.