The Effect of Dual Task on Manual Ability Performance in Children With Cerebral Palsy

The aim of the study is to investigate the effect of dual task conditions on manual dexterity performance in young people and children with CP between the ages of 7-18 and to compare it with their peers.

Evaluations to be made in the study (children with CP) and control (typically developing peers) groups:

* Demographic information, Gross Motor Function Level (GMFCS), Manual Skills Classification System (MACS) and dominant extremity will be noted and the evaluation will begin by applying the Abilhand Kids questionnaire.
* Firstly, the child's performance on a single cognitive task will be evaluated in a supported sitting position on a chair. The cognitive task will be the n-back task (counting down task) to be applied in accordance with the level of the child or young person.
* Using the Visual Analogue Scale (VAS), participants will be asked to score the difficulty of the cognitive task as a number between 0 and 10.
* In order to evaluate the single motor performance of manual skills, the 9-Hole Test will be applied and the times will be recorded by asking to write a given paragraph.
* Dual task evaluations will be administered by giving a simultaneous cognitive task while administering the 9-Hole Test and writing a paragraph.
* In order to reveal the dual-task cost (DTC), dual-task performance will be subtracted from single-task performance and the difference will be calculated in seconds.
* The Body Control Measurement Scale will be applied for body evaluation purposes.

As a result of this study, the changes in manual dexterity and cognitive performance in dual-task conditions in children and adolescents with CP will be revealed. Additionally, changes in this performance in dual-task situations will be compared with a control group of typically developing children.

In the literature, balance or walking postural tasks are mostly used in dual-task studies for children and young people with Cerebral Palsy (CP). However, dual task tasks performed during manual skills in daily life have not been adequately researched. The aim of the study is to investigate the effect of dual task conditions on manual dexterity performance in young people and children with CP between the ages of 7-18 and to compare it with their peers. Although studies on this subject in the world are limited.

MATERIAL AND METHOD:

Evaluations to be made in the study (children with CP) and control (typically developing peers) groups:

-Demographic information, Gross Motor Function Level (GMFCS), Manual Skills Classification System (MACS) and dominant extremity will be noted and the evaluation will begin by applying the Abilhand Kids questionnaire.

Abilhand Kids is a questionnaire that evaluates children's upper extremities bimanually, has proven validity and reliability, and includes 21 questions for families about the common tasks their children undertake in daily life activities.

* Firstly, the child's performance on a single cognitive task will be evaluated in a supported sitting position on a chair. The cognitive task will be the n-back task (counting down task) to be applied in accordance with the level of the child or young person.
* Using the Visual Analogue Scale (VAS), participants will be asked to score the difficulty of the cognitive task as a number between 0 and 10.
* In order to evaluate the single motor performance of manual skills, the 9-Hole Test will be applied and the times will be recorded by asking to write a given paragraph.
* Dual task evaluations will be administered by giving a simultaneous cognitive task while administering the 9-Hole Test and writing a paragraph.
* In order to reveal the dual-task cost (DTC), dual-task performance will be subtracted from single-task performance and the difference will be calculated in seconds.
* The Body Control Measurement Scale will be applied for body evaluation purposes.

The scale consists of 15 items in total (subscales 5, 7 and 3 items, respectively). Items are scored on an ordinal scale of 2, 3, and 4 points. Although the total score of the scale varies between 0-58 points, higher scores indicate better performance. The Turkish validity and reliability of the survey was conducted.

As a result of this study, the changes in manual dexterity and cognitive performance in dual-task conditions in children and adolescents with CP will be revealed. Additionally, changes in this performance in dual-task situations will be compared with a control group of typically developing children.

Eligibility Criteria:
Inclusion Criteria:

* Participants must be between the ages of 7-15,
* Not having a chronic disease.

Exclusion Criteria:

* Participants must have had Botulinum Toxin applied to the upper extremity in the last 6 months
* Participants must have had a health problem or had an operation that would affect the musculoskeletal system or dexterity performance in the last year (EX: Distal radius fracture).
* Having concentration problems such as attention deficit hyperactivity disorder (ADHD).
* Not volunteering to participate in the study and not signing a consent form.