Health Sciences

Multi-modal therapies for children with motor impairments

Studies in this program aim to investigate the effect of interventions that are currently available, that focus on improving activity capacity and performance in children with primary motor impairments such as cerebral palsy. Investigations of therapies, such as upper limb orthoses for children with cerebral palsy; coaching for parents of children involved in therapy programs; measurement development and validation as needed; and knowledge translation research including systematic reviews of intervention effectiveness are examples of work in this program.

Program Leader: Professor Christine Imms

Open all

Project team: Professor Christine Imms, Dr Brooke Adair, Dr Melinda Randall, Professor Dinah Reddihough (Murdoch Childrens Research Institute), Professor Rob Carter (Deakin University), Dr Brian Hoare (Monash Health), Dr Susan Greaves (Royal Childrens Hospital), Dr Margaret Wallen (Cerebral Palsy Association), Associate Professor Catherine Elliott (Curtin University), Dr Elizabeth Bradshaw, Ms Sophy Shi (Deakin University), Ms Francesca Orsini (Murdoch Childrens Research Institute), and doctoral students: Mr Simon Garbellini, Ms Corrin Walmsley.

These concurrently run randomised controlled trials aim to assess whether the provision of a serially adjusted wrist/hand orthosis (WHO), in combination with usual multi-disciplinary care, prevents or reduces muscle contracture/stiffness. Secondary analyses will focus on the impact of WHO provision on pain, activity performance, participation and quality of life. A cost benefit analyses of the intervention will also be performed. Eligible participants are children with cerebral palsy; the iWHOTrial focusses on young children less than 24 months at study enrolment and the MITrial will assess WHO provision for children ages 5 to 15 years. The effect of the WHO will be monitored over a 3 year period, with assessments occurring every 6 months. Throughout the projects three novel measurement devices will also be designed, tested and validated for use with this population. The results will inform us as to whether rigid WHOs are needed, or if activity-based therapy alone is sufficient to prevent or reduce the development of musculo-skeletal impairments in children with cerebral palsy. Published evidence from the trial will inform families, practitioners and policy makers regarding clinical and cost effectiveness of WHO to reduce impairment and promote activity and participation in young children with cerebral palsy.

This project is embedded within the NHMRC funded Centre for Research Excellence – Cerebral Palsy. Both trials are registered on the Australian and New Zealand Trials Registry.

Sample wrist hand orthosis

Sample wrist hand orthosis

Project team: Professor Christine Imms, Professor Iona Novak (Cerebral Palsy Alliance), Professor Dinah Reddihough (Murdoch Childrens Research Institute), Professor H. Kerr Graham (The Royal Childrens Hospital), Professor Nora Shields (La Trobe University); our associate investigators from partner organisations including Ms Sarah Foley (Kids Plus), Dr Elspeth Froude and Ms Lyndsay Quarmby (St Giles Society), Ms Kerry Evans, Novita Childrens Services, Ms Marisa McCabe (Yooralla), Ms Petra Karlsson and Ms Hayley Smithers-Sheedy (Cerebral Palsy Alliance), Dr Melinda Randall (ACU), Dr Adrienne Harvey (Murdoch Childrens Research Institute).

This partnership project aims to improve research implementation in allied health professionals (AHPs) who work with children and young people with cerebral palsy (CP). CP affects 34,000 Australians and is the most common form of childhood physical disability. Many people with CP require health and therapy services throughout their life. The care they are offered should be effective and evidence-based; however there is frequently a delay in accessing and adopting new research findings into day-to-day clinical practice.

This partnership project involves children and young people aged 3-18 years with cerebral palsy, and their families. It also involves the Physiotherapists, Occupational Therapists and Speech Pathologists who work with these children and young people, and with the management in the organisations that the children and families attend for their therapy services. Partner organisations are Cerebral Palsy Alliance in New South Wales; Yooralla and Kids Plus in Victoria; St Giles Society in Tasmania; and Novita Childrens Services in South Australia. Other organisations involved with the study are Murdoch Childrens Research Institute, Victorian Paediatric Rehabilitation Services and La Trobe University.

This study involves implementing four different strategies in each of four organisations and comparing outcomes to one organisation in which the strategies are already embedded. The four strategies are: knowledge brokers, access to an on-line evidence library specifically for CP; provision of negotiated evidence-based education and training; and routine use of evidence-based assessment procedures. Findings of this study will inform families, services and funding agents like the National Disability Insurance Agency about what constitutes an evidence-informed service for children with cerebral palsy.