DOI: 10.5061/dryad.5r06h3c
title: Data from: Cognitive approach to rehabilitation in children with hyperkinetic movement disorders post-DBS

description: Objective: This proof-of-concept feasibility trial examined the potential
 of the Cognitive Orientation to daily Occupational Performance (CO-OP)
 ApproachTM to augment deep brain stimulation (DBS) outcomes in
 childhood-onset hyperkinetic movement disorders (HMD) including dystonia
 and dyskinetic cerebral palsy. Methods: Single case experimental design
 using multiple baseline as N-of-1 trial comprised of 10 intervention
 sessions, with replications across participants (n=10). Treatment focused
 on three participant-selected goals. Transfer was assessed on two
 additional untreated goals. Individuals enrolled were 6-21 years of age,
 had DBS in situ and sufficient manual ability. Primary outcome was
 functional performance change on the Performance Quality Rating
 Scale-Individualized (PQRS-i) measured before, during, post-treatment, and
 at 3-months follow-up. Assessors of outcome were blinded to time of
 assessment, number of intervention session and treatment allocation. To
 measure effect size, a non-overlapping index, Tau-U, was used. Feasibility
 parameters were captured. Results: One participant withdrew before
 baseline assessment. Effect sizes of at least 0.66 were seen at both
 post-treatment and follow-up with all participants showing improvements in
 at least one trained goal in PQRS-i. Six participants improved on all
 three goals and two improved on two trained goals. Two children showed
 deterioration in one trained goal each. Transfer to untrained goals was
 observed in three participants for a total of five goals. CO-OP was
 feasible and acceptable to all participants. Conclusion: A
 cognitive-based, task-oriented approach to support performance of
 personally relevant functional skills enabling participation is acceptable
 in childhood-onset HMD post-DBS. Further, preliminary efficacy to improve
 outcomes and proof of concept with CO-OP has been established in this
 population. Classification of Evidence: This study provides Class III
 evidence that for children with hyperkinetic movement disorders who had
 undergone DBS, CO-OP improves performance of personally relevant
 functional skills.
description: Figure 2. Child 3 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 2.pdfFigure 3. Child 4 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 3.pdfFigure 4. Child 5 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 4.pdfFigure 5. Child 6 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 5.pdfFigure 6. Child 7 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 6.pdfFigure 7. Child 8 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 7.pdfFigure 8. Child 9 PQRS-i
 scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 8.pdfFigure 9. Child 10
 PQRS-i scoresScores by a blind rater
 for 5 self-selected goals using the PQRS-i. Graphs created using GraphPad
 Prism software.Gimeno_SCED1_figure
 9.pdf