Cerebral palsy (CP) is one of the most frequent neurodevelopmental deseases. The brain lesion may disturb upper extremity functioning in children with cerebral palsy (CP). This thesis aims to create a therapeutic program focused on movability of upper limbs in school-aged children with CP and and verify the efficiency of this therapeutic program. Another goal is to consider the applicability of the Jebsen Taylor Test of Hand Function for assessment of hand function in children with CP. The theoretical part deals elaborately with cerebral palsy, therapeutic interventions in children with CP and its efficiency according to the evidence based medicine. This part also deals with standardized assassment tools and pays close attention to the Jebsen Taylor Test of Hand Function (JTTHF) and the Manual Ability Classification System (MACS). The practical part presents six case studies of children with cerebral palsy who attended the occupational therapy three times a week over three weeks. The created therapeutic program includes three areas focused on the bimanual training, grips and grafomotorics. This program was appropriate for four of six children patients. The program was too hard for children with quadruparesis classified as MACS IV. The other children were classified as MACS II. The efficiency of...

In der vorliegenden Arbeit wurde eine vergleichende Analyse der Hand- und Armfunktion von gesunden rechtshändigen alten und jungen Personen vorgenommen und dabei insbesondere der modulare Aufbau von Greifmustern analysiert. Es wurden vier Handfunktionstests durchgeführt: eine Tapping-Aufgabe an einer Computertastatur, eine Handkraftmessung mit dem Martin-Vigori-meter, der Jebsen-Taylor Test of Hand Function und eine standardisierte Greifaufgabe nach vier Greifobjekten (Münze, Kronkorken, kleine Dose, große Dose) mit Aufzeichnung der Handbewe-gungen mit einem Sensorhandschuh (Wü-Glove) und der Armbewegungen mit ultraschallemittierenden Markern. Die Auswertung der Greifaufgabe erfolgte zum einen nach kinematischen Aspekten (Dauer, maximale Geschwindigkeit, maximale Beschleunigung), zum anderen wurde mittels Hauptkomponentenanalyse der modulare Aufbau von Greifmustern untersucht und mittels Ähnlichkeitsanalysen (u.a. Mahalanobis-Distanz) die Finger- und Armkonfigurationen bei Objektkontakt verglichen. Daten von 66 Probanden wurden ausgewertet. Vollständige Datensätze lagen von 10 jungen (20-33 J.) und 10 alten (61-85 J.) Probanden vor. Junge Probanden zeigten erwartungsgemäß eine größere Handkraft und Fingerschnelligkeit und eine bessere Leistung im Jebsen-Taylor Test of Hand Function. Die Greifmuster der älteren Probanden waren verglichen mit den jungen Probanden interindividuell variabler, gleichzeitig aber ökonomischer organisiert. Diese ökonomischere Organisation kann als Folge impliziter Lernprozesse bei individuell unterschiedlichen Greiferfahrungen in Abhängigkeit des Alters gedeutet werden. Zunehmendes Lebensalter muss somit nicht nur mit einer Abnahme motorischer Funktionen verbunden sein, sondern kann auch positive Auswirkungen auf die Steuerung der Handfunktion in Form einer Optimierung von Greifmustern durch implizite Expertise haben.

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Doctor of Philosophy / Department of Horticulture, Forestry, and Recreation Resources / Candice A. Shoemaker / The objectives of this study were to determine exercise intensity of common gardening tasks in older adults and to investigate if older gardeners meet the physical activity (PA) recommendations (intensity and time) through their daily gardening. Kinds of gardening tasks, body postures, and bodily pain while gardening of older gardeners were investigated and the possibility of gardening as a predictor for a physically active lifestyle and life satisfaction in older adults was determined. Older participants were randomly recruited from the community of Manhattan, KS. To determine the exercise intensity of gardening, the heart rates of older adults were measured by radiotelemetry during gardening or garden tasks, and then oxygen uptake and energy expenditure were measured via indirect calorimetry using a submaximal graded exercise test. Overall health conditions by the Short Form 36 Health Survey (SF-36), hand functions by hydraulic hand dynamometer and pinch gauge, and bone mineral density (BMD) by dual-energy x-ray absorptiometry were measured. An observational study and weekly logs were conducted to study kinds of gardening, postures, and bodily pain of older gardeners. The Community Healthy Activities Model Program for Senior (CHAMPS) questionnaire was used to measure leisure-time PAs (frequency per week of all PAs and calories expended per week in all PAs). In conclusion, the nine gardening tasks were found to be low to moderate intensity PA in healthy older adults (1.6 ± 3.6 METs). Gardening observed was moderate intensity (3.8 ± 1.4 METs) PA in older adults and the subjects met the PA recommendation, which is at least 30 minutes of moderate intensity PA on most days of the week through their daily gardening (moderate intensity; average 33 hrs/wk in May and 15 hrs/wk in June and July). The older gardeners showed higher values for hand function and some SF-36 domains (physical function, bodily pain, and physical summary) than older non-gardeners. Gripping, stooping, lifting, stretching, walking, standing, kneeling, sitting, and squatting were observed while older adults gardened and lower back pain was the main bodily pain reported. Furthermore, gardening was found to be a predictor for leading a physically active lifestyle and high life satisfaction in older adults.