A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Occupational Therapy. 2012 / This study investigated the effects of a five-day “block” of intensive NDT on the gross motor function and occupational performance of 34 children with CP from an under resourced rural area of South Africa, functioning at GMFCS Levels I-V. The repeated measures research design used two preintervention (baseline of change) and two post-intervention (immediate and sustained change) assessments. The GMFM–66 and PEDI–Modified Functional Skills Scale (MFSS) were used to assess change in motor skills and occupational performance in self-care, mobility and social function over a 21 week period. The intervention included individual NDT therapy, caregiver training and provision of adapted equipment. Participants showed significant positive improvement in scores postintervention compared with the pre-intervention period, in: GMFM-66 total score (p=0.050); PEDI-MFSS: self-care skills (p=0.001), mobility (p=0.002) and social (p=0.000). The greatest gains were made in the self-care domain. In this sample, positive change was effected by a five-day intensive NDT programme.

Thesis (M.Sc.(Occupational Therapy))--University of the Witwatersrand, Faculty of Health Sciences, 2013. / Hand function deficits are associated with Cerebral Palsy (CP), and lead to diminished participation in activities of daily living (ADL’s), play and school. A longitudinal experiment incorporating a pre-test-post-test design was used with a convenience sample of 28 children with spastic quadriplegic CP randomly assigned to two groups. Both groups received monthly occupational therapy and a home programme over the three month period, the intervention group received an additional neoprene thumb abductor splint. The Quality of Upper Extremity Skills Test (QUEST) was administered at baseline and again at 3 months to assess changes in underlying impairments contributing to hand function. There were no statistically significant differences between final scores in the control and intervention groups, but a clinically significant improvement in score with the splint on for the intervention group was found. Wearing the splint during functional tasks may be beneficial in improving underlying impairments.

The aim of this study was to determine the effects of an eight-week weight bearing exercise program coupled with whole body vibration (WBV) on gross motor function, functional mobility and spasticity in hemiplegic type cerebral palsied school going children. The experimental group was compared to a control group undergoing the same exercise program. The control group excluded WBV training. Fifteen children participated in the study nine females and six males. There were eight children with right hemiplegia and seven with left hemiplegia; all children had gross motor classification (GMFCS) of Level 1. Significant improvements were seen in both groups for gross motor function. There was no difference in the amount of change seen between the two groups. A decline was noticed in the functional mobility assessment. The findings of this study demonstrated that both the children in the control and the experimental groups showed significant improvements in the GMFM scores after a weight bearing exercise program. The children in the experimental group who received WBV while exercising showed significant improvement from baseline to completion of the study compared to the group that did weight bearing exercise alone; better carry over effect in this group from WBV. Time up and down stairs (TUDS) and modified ashworth scale (MAS) scores showed less convincing results and need further investigation. Further research is required to determine the most effective and efficient way of managing children with cerebral palsy in a resource poor area.

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