Publications by authors named "Delphine Dispa"

7 Publications

  • Page 1 of 1

Interrater Reliability of Activity Questionnaires After an Intensive Motor-Skill Learning Intervention for Children With Cerebral Palsy.

Arch Phys Med Rehabil 2019 09 18;100(9):1655-1662. Epub 2019 Feb 18.

Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium. Electronic address:

Objective: To investigate the reliability of parents-reported activity questionnaires after a motor-skill learning intervention for children with cerebral palsy (CP). We hypothesize that the intervention process might influence parental judgment.

Design: Double-blind randomized trial.

Setting: Conventional therapy was delivered in the usual context while intensive intervention was provided at the Catholic University of Louvain.

Participants: Children with CP (N=41; age range 5-18y, Gross Motor Function Classification System I-IV) were randomized to a control group (CG) (n=21, 2 dropouts) receiving conventional therapy or an intervention group (IG) (n=20) receiving hand-arm bimanual intensive therapy-including lower extremities (HABIT-ILE).

Interventions: Conventional therapy (mostly neurodevelopmental) was delivered as ongoing treatment (1-5 times/wk). HABIT-ILE, based on motor-skill learning, was delivered over 2 weeks. All children were assessed at T1 (baseline), T2 (3wk after baseline) and T3 (4mo after baseline).

Main Outcomes Measures: ABILHAND-Kids and ACTIVLIM-CP questionnaires rated by parents (perception) and 2 examiners (videotapes).

Results: Agreement (level/range) between examiners was systematically almost perfect (P≤.001). At baseline, moderate to almost perfect agreement (level/range) was observed between parents and examiners (P≤.001). At T2 and T3, a similar agreement (level/range) was observed for the CG. For the IG, a similar level of agreement was observed, but the range of agreement varied from poor to almost perfect (P≤.001), with parents estimating higher performance measures compared to examiners after intervention. Higher performance was associated with higher satisfaction scores of the child's functional goals at T3.

Conclusion: Parents and examiners have a similar perception of the child's performance at baseline and during conventional therapy. Their perceptions are less congruent after a motor-skill learning intervention, probably due to the goal-oriented process of the intervention. Therefore, our results favor the use of blind observations of home-videotaped items after intensive motor-skill learning interventions.
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September 2019

Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery.

Front Hum Neurosci 2016 13;10:442. Epub 2016 Sep 13.

Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium.

Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation.
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September 2016

Influence of vision and posture on grip-lift task parameters in healthy adults.

Int J Rehabil Res 2014 Dec;37(4):354-60

aInstitute of Neuroscience bPhysical Medicine and Rehabilitation Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.

The grip-lift task enables a quantitative assessment of grasping ability. Patients are regularly assessed in a supine position, which offers a different view of the grasped object from that in the sitting position. To our knowledge, no data are currently available on the influence of posture and vision on grip-lift task parameters. We therefore aimed to determine the effects of posture and vision on these parameters. Twenty-six healthy right-handed adults performed grip-lift tasks with a manipulandum that measured different temporal and dynamic parameters in four conditions: sitting eyes open, sitting blindfolded, lying down eyes open and lying down blindfolded. A repeated-measures analysis of variance with two factors (vision and position) showed that the absence of vision affected all the parameters measured. The lying down position increased the time between the first contact with the object and the modification of the vertical force as well as the delay between the first increase of the horizontal force and the increase of the vertical force. In addition, there was a lower adaption of the horizontal force, required to squeeze the object, to the vertical force. Finally, the interaction of position and vision was associated with significant differences in the delay between the contact of each digit with the object, the maximum horizontal force and the ratio between the horizontal and vertical force during a static holding period. Both position and vision appear to affect the grip-lift task. Consequently, sequential assessments should be performed in the same condition to obtain reliable data.
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December 2014

Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial.

Neurorehabil Neural Repair 2015 Feb 11;29(2):183-92. Epub 2014 Jul 11.

Université catholique de Louvain, Institute of Neuroscience, Brussels, Belgium Université catholique de Louvain, Louvain Bionics, Louvain-la-Neuve, Belgium Université catholique de Louvain, Cliniques universitaires Saint-Luc, Brussels, Belgium.

Background: Several pilot studies have evoked interest in robot-assisted therapy (RAT) in children with cerebral palsy (CP).

Objective: To assess the effectiveness of RAT in children with CP through a single-blind randomized controlled trial.

Patients And Methods: Sixteen children with CP were randomized into 2 groups. Eight children performed 5 conventional therapy sessions per week over 8 weeks (control group). Eight children completed 3 conventional therapy sessions and 2 robot-assisted sessions per week over 8 weeks (robotic group). For both groups, each therapy session lasted 45 minutes. Throughout each RAT session, the patient attempted to reach several targets consecutively with the REAPlan. The REAPlan is a distal effector robot that allows for displacements of the upper limb in the horizontal plane. A blinded assessment was performed before and after the intervention with respect to the International Classification of Functioning framework: body structure and function (upper limb kinematics, Box and Block test, Quality of Upper Extremity Skills Test, strength, and spasticity), activities (Abilhand-Kids, Pediatric Evaluation of Disability Inventory), and participation (Life Habits).

Results: During each RAT session, patients performed 744 movements on average with the REAPlan. Among the variables assessed, the smoothness of movement (P < .01) and manual dexterity assessed by the Box and Block test (P = .04) improved significantly more in the robotic group than in the control group.

Conclusions: This single-blind randomized controlled trial provides the first evidence that RAT is effective in children with CP. Future studies should investigate the long-term effects of this therapy.
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February 2015

Impaired predictive and reactive control of precision grip in chronic stroke patients.

Int J Rehabil Res 2014 Jun;37(2):130-7

aInstitue of Neuroscience, Université catholique de Louvain bPhysical Medicine and Rehabilitation Unit, Cliniques universitaires Saint Luc, Brussels, Belgium.

Skilled hand movements require a precise coordination between the grip force and the load force. To coordinate those forces, we rely on both a predictive and a reactive control. On the basis of specific impairments observed previously in children with hemiplegic cerebral palsy, we aimed to assess the predictive or reactive nature of hand deficits in stroke patients. This case-control study was carried out with eight stroke patients and eight control participants. The load of a handheld object was rapidly increased by dropping a mass attached to the object. We tested predictive and reactive aspects of the movement in the same task as the drop was triggered either unexpectedly by the examiner (reactive condition) or by the patient himself (predictive condition). Deficits observed in the paretic hand were similar to those highlighted previously in children with hemiplegic cerebral palsy. Under predictive conditions, temporal deficits were observed after impact. Under reactive conditions, the reflex latency was slightly increased in the paretic hand. The nonparetic hand showed similar results to controls. The predictive mechanism is present but altered in the paretic hand. These alterations suggest an inability to anticipate the consequences of dynamic perturbations in the paretic hand only.
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June 2014

The effect of repetitive rhythmic precision grip task-oriented rehabilitation in chronic stroke patients: a pilot study.

Int J Rehabil Res 2013 Mar;36(1):81-7

Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.

Most chronic stroke patients present with difficulty in the manipulation of objects. The aim of this study was to test whether an intensive program of precision grip training could improve hand functioning of patients at more than 6 months after a stroke. This was a cross-over study; hence, at inclusion, the patients were randomly divided into two groups: one group started with the bilateral movement therapy and the other group started with the unilateral movement therapy. The patients were assessed on four separate occasions across a 12-week period: (a) at inclusion in the study, (b) 4 weeks later, immediately before the first rehabilitation session, (c) after 4 weeks of one therapy, and (d) after a further 4 weeks of the other therapy. Ten patients completed two consecutive 4-week sessions (1 h, 3 days/week) of therapy. The therapy comprised unilateral and bilateral repetitive grip-lift task-oriented rehabilitation with rhythmic auditory cueing. The grip-lift force coordination, digital dexterity, manual ability, and the level of satisfaction (with activities and participation) were assessed. A one-way repeated-measure analysis of variance across the four evaluations did not detect any objective improvement in the measured variables after 8 weeks of specific intensive training. Precision grip training was shown to not generate significant improvement in the grip-lift task, digital dexterity, manual ability, or satisfaction in chronic stroke patients.
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March 2013

A comparison between self-reported and observed activity limitations in adults with neuromuscular disorders.

Arch Phys Med Rehabil 2008 Sep;89(9):1720-3

Rehabilitation and Physical Medicine Unit, Université catholique de Louvain, Brussels, Belgium.

Objective: To investigate the agreement between the self-reported and examiner-reported difficulties of patients with neuromuscular disorders (NMDs) in performing daily activities at home.

Design: A comparison between 2 methods of administering a measurement instrument.

Setting: Neuromuscular reference center in a university hospital.

Participants: Adult patients (N=57) with diagnosed NMDs living at home.

Interventions: Not applicable.

Main Outcome Measure: The ACTIVLIM questionnaire.

Results: The intraclass correlation coefficient, model 2,1 (ICC(2,1)), between the measures was very good (ICC(2,1)=.87), indicating a good agreement between self-perceived and observed measures.

Conclusions: The use of ACTIVLIM as a self-reporting questionnaire is a valid method for assessing activity limitations in patients with NMD.
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September 2008