Hemiplegic cerebral palsy affects around 12000 children in the UK. Children with hemiplegia need lots of encouragement and practice to keep using the affected hand and arm. From here on, we will refer to the affected hand as the helper hand because it is our aim that this hand can help as much as possible in bimanual tasks. Sometimes it’s hard to get enough therapy for the helper arm and hand, yet most activities we do every day are much easier to do if the two hands are used together. Encouraging the use of both hands from an early age could help with independence later in life, and we know from research evidence, including our own, that repeated practice improves children's ability to use both arms and hands. We also know that this practice needs to be done often, preferably by spending some time on this each day. Play and leisure time provides a good opportunity for this.
We wanted to find lots of toys and games suitable for children age 3-10 years with hemiplegia, to encourage use of the helper hand and arm. Many of the activities require use of the two hands together. Often we have had to adapt the "rules" to get the most out of the games for children with hemiplegia. Each game was chosen to work on specific aspects of movement. We also wanted to have lots of variety so that you could find a range of games to suit your child’s interests and abilities as well as therapy needs.
The games and toys are aimed at supplementing other therapy your child may receive. They can be incorporated into your child’s playtime at home with you and are aimed to be fun! There are stepwise photos to guide you through the instructions.
The instructions were developed by Emma Kirkpatrick whilst undertaking a PhD at the Institute of Neuroscience, Newcastle University, supervised by Dr Anna Basu and with advice from senior paediatric occupational therapist Janice Pearse. Our research group is interested in therapies which can help children with hemiplegia to improve their hand function.
The project was funded by WellChild and by a Henry Miller studentship from Newcastle University. The instructions were made as part of a trial comparing two forms of play-based therapy to improve upper limb function in children with hemiplegia age 3-10 years. Can play-based therapy improve hand function in hemiplegia?
Kirkpatrick EV, Pearse JE, James P, Basu AP. Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomised controlled trial. 2016 - full text version available.
The trial was sponsored by the Newcastle upon Tyne Hospitals NHS Foundation Trust.
We would like to thank Ellie Meardon, Ceri Gillet, Blythe Wright and Ceit Jesmont for their input to this project.
Pearse JE, Cadwgan JE, Wisher V, Jesmont C, Mason-Burton P, Barry M, Jona James J, Kelly S, Basu AP. Feasibility Trial of Thumb Taping by Parents in Infants with Cerebral Palsy: Brief Report. Dev Neurorehabil 2019 (In Press).
Basu AP, Pearse JP, Watson R, Dulson P, Baggaley J, Wright B, Howel D, Vale L, Mitra D, Embleton N, Rapley T. Feasibility Trial of an Early Therapy in Perinatal Stroke (eTIPS). BMC Neurology 2018;18(1):102.
Marcroft C, Tstutsumi A, Pearse JE, Dulson P, Embleton ND, Basu AP. Current therapeutic management of perinatal stroke with a focus on the upper limb: a cross sectional survey of UK physiotherapists and occupational therapists. Phys Occup Ther Pediatr 2018 13:1-17.
Lord C, Rapley T, Marcroft C, Pearse J, Basu AP. Determinants of parent-delivered therapy interventions in children with cerebral palsy: A qualitative synthesis and checklist. Child Care Health Devel 2018;44(5):659-669
Cadwgan J, Pearse J, Devlin A, Basu A. Fifteen Minute Consultation: Management of the upper limb in unilateral cerebral palsy. Arch Dis Child 2018 (In Press).
Goodwin J, Lecouturier J, Basu A, Colver A, Crombie S, Smith J, Howel D, McColl E, Parr JR, Kolehmainen N, Roberts A, Miller K, Cadwgan J. Standing Frames as Postural Management for Children with Cerebral Palsy: A Mixed Methods Feasibility Study. Health Technol Assess. 2018;22(50):1-232
Basu AP. One Hand Clapping. Dev Med Child Neurol 2018; 60(8):739-740
Goodwin J, Lecouturier J, Crombie S, Smith J, Basu A, Colver A, Kolehmainen N, Parr JR, Howel D, McColl E, Roberts A, Miller K, Cadwgan J. Understanding Frames: A qualitative study of young people’s experiences of using standing frames as part of postural management for cerebral palsy. Child Care Health Devel 2018; 44(2):203-211
Goodwin J, Colver A, Basu A, Crombie S, Howel D, Parr J, McColl E, Kolehmainen N, Roberts A, Lecouturier J, Smith J, Miller K, Cadwgan J. Understanding Frames: A UK survey of parents and professionals regarding the use of standing frames for children with cerebral palsy. Child Care Health Devel 2018; 44(2):195-202
Basu AP, Kirkpatrick EV, Wright B, Pearse J, Best KE, Eyre JA. The Tyneside Pegboard Test: Development, validation and observations in unilateral cerebral palsy. Dev Med Child Neurol 2018. In Press, Open Access:
http://onlinelibrary.wiley.com/doi/10.1111/dmcn.13645/abstract
See also YouTube video explaining it all: https://www.youtube.com/watch?v=FcaDrZcLlOg
Basu A, Pearse J, Baggaley J, Watson R, Rapley T. Participatory design in the development of an early therapy intervention for perinatal stroke. BMC Pediatrics 2017 17:33
Basu AP. Mapping corticospinal tract projection patterns in unilateral CP. Dev Med Child Neurol 2017; 59(1):10-11
James P, Basu A, Marcroft C. Lacey Assessment of Preterm Infants (LAPI). J Physiother. 2017; 63(4), 267.
Pearse J, Basu AP. ABILHAND-Kids questionniare: Responsive to change or in need of change? Dev Med Child Neurol 2017; 59(5):457
Basu A, Pearse J, Kirkpatrick EV. To copy or not to copy, that is the question! HemiHelp magazine 2016; 98, 32-33.
Basu A, Baggaley J, Simpson K. Case notes review of perinatal stroke in term and preterm infants in the Northern Region over a 10 year period. Arch Dis Child 2016; 101(Suppl 1):A60.
Baggaley J, Kirkpatrick E, Pearse J, Basu AP. Experiences of using the ABILHAND-Kids questionnaire for children with unilateral CP in a UK setting. APCP Journal 2016; 7(1), 23-32.
Kirkpatrick EV, Pearse JE, James P, Basu AP. Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomised controlled trial. Dev Med Child Neurol. 2016;58(10):1049-56
Basu AP, Taylor PN, Lowther E, Forsyth EO, Blamire AM, Forsyth RJ. Structural connectivity in an anarchic hand case following traumatic callosal damage in a young person. BMC Neurology 2015, 15:234. Basu AP. Pathways to good hand function after early brain injury. Dev Med Child Neurol. 2015;57(10):897-898
Basu AP, Clowry G. Improving outcomes in cerebral palsy with early intervention: new translational approaches. Front Neurol. 2015 Feb 11;6:24. doi: 10.3389/fneur.2015.00024. eCollection 2015.
Khong K, Serradilla J, Baker E, Preston H, Lambden C, Pearse J, Kirkpatrick E, Eyre J, Basu A. How does the Assisting Hand Assessment relate to relative upper limb movement measured by actigraphy in children with hemiplegia? Dev Med Child Neurol. 2015;57(S1):10
Kisler J, Pearse J, Wisher V, Robson S, Kelly S, Gardner D, Basu A. Can Taping improve hand posture and use in infants with asymmetric cerebral palsy? Dev Med Child Neurol. 2015; 57(S1):18
Forsyth RJ, Basu AP. The promotion through rehabilitation of recovery after acquired brain injury in children. Invited Review. Dev Med Child Neurol. 2015;57(1):16-22
Basu AP. Pathways to good hand function after early brain injury. Dev Med Child Neurol. 2015; 57(10):897-898
Basu AP, Pearse J, Kelly S, Wisher S, Kisler J. Early intervention to improve hand function in hemiplegic cerebral palsy. Frontiers in Neurology 12/2014; 5(281) doi: 10.3389/fneur.2014.00281.
Kirkpatrick E, Pearse J, James P, Eyre J, Basu AP. Parent-delivered play-based therapy improves hand function in hemiplegic cerebral palsy. Dev Med Child Neurol. 2014; 56(S4):28.
Basu AP. Early intervention in perinatal stroke: Opportunities and challenges. Invited Review. Dev Med Child Neurol. 2014; 56(6):516-21
Marcroft C, Dulson P, Basu AP, Hearn R, Embleton N. Does the Lacey Assessment predict cerebral palsy in extremely preterm infants? A pilot study. ACPC Journal 2014; 5(2): 29-34
Dunford J, Kirkpatrick EV, Pearse J, Basu AP. Compliance with a parent-delivered play-based therapy approach to upper limb rehabilitation in hemiplegic cerebral palsy. Dev Med Child Neurol. 2013; 55(S2):33.
Kirkpatrick EV, Pearse J, Eyre JA, Basu AP. Motor planning ability is not related to lesion side or functional manual ability in children with hemiplegic cerebral palsy. Experimental Brain Research 2013; 231(2):239-47
Basu AP, Kirkpatrick EV, Pearse J, Boundford E, Gibson M, Eyre J. A. Quantification of bimanual dexterity deficits in children with hemiplegia with a modified peg test. Proceedings of the 4th International Cerebral Palsy Conference, Pisa, October 2012, p86-87.
Basu A, Eyre J. A plea for consideration of the less affected hand in therapeutic approaches to hemiplegia. Dev Med Child Neurol. 2012;54(4):380.
Basu AP, Pearse J, Kirkpatrick EV, Ling ITC, Tan GSL, Eyre JA. Raising awareness of the myth of the “unaffected hand” in childhood hemiplegia. Pediatr Res. 2011; 70(5):152.
Basu A, Horvath R, Esisi B, Birchall D, Chinnery PF. Recurrent stroke-like episodes in X-linked Charcot-Marie-Tooth disease. Neurology. 2011;77(12):1205-6.
Basu A, Graziadio S, Smith M, Clowry GJ, Cioni G, Eyre JA. Visual cortical neurophysiology with ipsilateral sensorimotor cortical lesions. Ann Neurol. 2010;68(1), 118-119.
Graziadio S, Basu A, Tomasevic L, Zappasodi F, Tecchio F, Eyre JA. Developmental tuning and decay in senescence of oscillations linking the corticospinal system. J Neurosci. 2010;30(10):3663-74.
Basu A, Graziadio S, Smith M, Clowry GJ, Cioni G, Eyre JA. Developmental plasticity connects visual cortex to motoneurons after stroke. Ann Neurol. 2010;67(1):132-6.
Basu AP, Turton AJ, Lemon RN. Activation of ipsilateral upper limb muscles by transcranial magnetic brain stimulation in man. J Physiol (Lond) 1994;479.P, 144P