The Effect of Fine Motor Skills Training Through Telerehabilitation in Children With Diplegic Cerebral Palsy

Primary outcomes

1. Assessment of Children's Hand Skills (ACHS)

   Time frame: 8 weeks

   ACHS is an observational assessment that measures the effectiveness of manual dexterity in children aged 2-12 years when participating in meaningful activities. Scoring items are categorized as: manual gestures, body-related dexterity, arm-hand use, adaptive dexterity hand use, general quality, and bimanual skills. A six-level Likert scale is used to score all skill items (Chien, Brown, & McDonald, 2010; Chien et al, 2011; Chien & Brown, 2012). The application of this test takes about 10 minutes.

2. Minnesota Handwriting Assessment

   Time frame: 8 weeks

   The Minnesota Handwriting Assessment is a writing quality assessment that includes copying seven words containing all the letters of the alphabet (Guzman Pasculli, Hiraga, & Pellegrini, 2017). Evaluation scores six components of the text: speed, legibility, form, alignment, size and spacing (Alhussaini. Meram & Buragada, 2016). The Turkish adaptation, validity and reliability of the Minnesota Handwriting Assessment was performed by Kavak and Bumin (Kavak & Bumin, 2006). This assessment takes less than 5 minutes to apply.

3. Shriners Hospital Upper Extremity Evaluation (SHUEE)

   Time frame: 8 weeks

   SHUEE is an assessment developed to measure upper extremity function in children with hemiplegic cerebral palsy. SHUEE is a video-based assessment administered by an occupational therapist using standardized objects and tasks. The evaluation takes about 15 minutes and is then scored by the occupational therapist (Davids, Piece, Wagner et al, 2006). Turkish validity and reliability of SHUEE was done by Bumin et al. (Bumin, Özsezen, & Yıldız, 2018).

4. Bruininks-Oseretsky Test of Motor Proficency 2- Short Form (BOT-2 SF)

   Time frame: 8 weeks

   BOT-2 is a tool that is frequently used in the evaluation of psychomotor characteristics in individuals aged 4-21 years (Jirovec, Musalek, & Mess, 2019).

   It is available in two versions, full form and short form. Four areas of psychomotor characteristics can be measured with BOT-2: (1) fine manual control, (2) accuracy and integrity, (3) manual coordination, and (4) physical coordination (Jirovec et al, 2019).

   In our study:

   • Item 2 of the bilateral coordination subtest,
   • Item 3, 4, 5 and 8 of the visual motor control subtest
   • Item 7 of the upper extremity speed and motion accuracy subtest, will be applied and scored.

   The application of these substances takes approximately 5 minutes. Since BOT-2 is a motor assessment test, there is no need for a Turkish validity and reliability study to be performed.

5. Canadian Occupational Performance Measure

   Time frame: 8 weeks

   COPM is a client-centered assessment tool used in occupational therapy (Carswell, McColl, Baptiste et al, 2004; Harris & Eng, 2004; Parker & Sykes, 2006; Enemark Larsen, Jessen Winge, & Christensen, 2019) The COPM assessment helps individuals to identify, prioritize and evaluate their occupational performance difficulties (Law, Baptiste, Carswell et al, 2015; Enemark Larsen et al, 2019). The Turkish adaptation, validity and reliability of the COPM were made by Torpil et al. (Torpil, Ekici, & Bumin, 2017). This assessment will take approximately 20 minutes.