Effect of Hand Exercises on Hand Grip Strength and Manual Ability in Children With Visual Impairment

Effect of Hand Exercises With and Without Sensory Stimulation on Hand Grip Strength and Manual Ability in Children With Visual Impairment

Development of the visual system immediately starts after birth via visual stimuli and interactions with the environment. The World Health Organization (WHO) has categorized visual impairments with respect to the best-corrected visual acuity as follows: blindness (Snellen visual acuity of 3/30), severe visual impairment (Snellen visual acuity between 6/60 and 3/30), moderate visual impairment (Snellen visual acuity between 6/18 and 6/60), and mild or no visual impairment (Snellen visual acuity of 6/18). The proper function of hands, particularly in delicate activities, depends on the interaction between the various regions of the brain, particularly, the sensory and motor cortex. Sensory stimulation can be used in such children to improve their manual dexterity and therapeutic interventions can be applied to gain hand strength. Developing skillful hands is a necessity in blind children as it often compensates for their missing vision. This study will focus on effectiveness of hand grip strength and manual ability with sensory stimulation in children with moderate to severe visual impairment.

Theraputty hand exercises and sensory stimulation techniques will be used.

Randomised control trial will be conducted with sample size 20. 20 participants will be included in the study. There will be 10 individuals who will receive hand exercises along with sensory stimulation to improve hand grip strength and manual ability and 10 Individuals who will only receive hand exercises to improve hand grip strength and manual ability. Grip strength and will be analyzed using hand dynamometer. For manual dexterity, box and block test will be used. Grip strength and manual dexterity will be analyzed before and after the intervention.Group A individuals will only receive hand exercises to improve hand grip strength and manual ability. Group B individuals will receive hand exercises along with sensory stimulation to improve hand grip strength and manual ability.

Inclusion Criteria:

• Children diagnosed with moderate (Snellen visual acuity between 6/18 and 6/60) to severe (Snellen visual acuity between 6/60 and 3/30) congenital visual impairment. (9)
• Children diagnosed with bilateral congenital visual impairment. (9)
• No prior exposure to therapeutic interventions given to hands. (9)
• Children who can understand English or regional Urdu language. (9)
• Children aged above 6-12 years (9)
• Children of either gender will be included.

Exclusion Criteria:

• Children with any orthopedic problem related to hand. (9)
• Children who went through any surgery of hands or eyes. (9)
• Children with any neurological issues related to hand. (9)
• Those who were unable to communicate or unable to hear well .(5).
• Children diagnosed with complete blindness (Snellen visual acuity of 3/30) .(5).
• Non-co-operative patients