Magic Camp for Children With Hemiplegic Cerebral Palsy

Magic Camp for Children With Hemiplegic Cerebral Palsy

The proposed study will test the feasibility and effectiveness of a "Magic Camp" in children with spastic hemiplegic cerebral palsy (CP). A single group pretest-posttest design (n=10) will be used to investigate the immediate (2 weeks) and longer-term effect (3 months) of a "Magic Camp" on improving upper limb motor function and health-related quality of life (HRQoL) in children with hemiplegic CP.

This project will employ a single group pretest-posttest design to investigate the impact of a "Magic Camp" on the improvement in upper limb motor function, health-related quality of life, and emotional stress among children with spastic hemiplegic CP. After the baseline evaluation, eligible participants will complete one-on-one "magic trick" training 3-hours per day for 2 consecutive weeks. The primary outcome measures will be unimanual function as measured by the Jebsen Taylor Test of Hand Function, bimanual coordination as measured by kinematic parameters using motion analysis, and spontaneous use of the more affected limb in real-life activities that demand the use of both hands as measured by the Children's Hand Experience Questionnaire. Secondary outcome measures will include HRQoL as measured by the Cerebral Palsy Quality of Life Questionnaire, in-depth dyad qualitative interviews of the caregivers and children, and emotional stress as measured by the fingernail cortisol levels.

Inclusion Criteria:

• spasticity with Modified Ashworth Scale grades between 1 and 3;
• ability to lift the more affected arm 15 cm above a table surface;
• impairment of hand function at levels I to III of the Manual Activity Classification System
• ability to grasp and release light objects with the more affected hand
• largely nonuse of the more affected hand in daily activities as determined by the Pediatric Motor Activity Log
• are interested in learning magic tricks
• have the cognitive and social ability to participate in a camp setting;
• ability to follow directions in English; and
• ability to remember simple sequences of actions to perform magic tricks.

Exclusion Criteria:

• severe muscle spasticity or fixed contracture in the more affected limb that limits functional arm and hand use
• dystonia
• severe visual or auditory disorders that prevent learning and carrying out the magic tricks
• serious or recurring medical complications
• participation in intensive upper limb intervention and/or musculoskeletal and tone management treatments, dorsal rhizotomy, or surgery on the upper limb in the previous 6 months or anticipated within subsequent 6 months
• start muscle relaxant within the last 3 months; or
• plan to move to another state within the next 6 months.