Effect of Task Oriented Training and Xbox KinectTM on Hand Function in Pediatric Burn

Study Overview
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Brief Summary
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The Jebsen-Taylor Hand Function Test and Canadian Occupational Performance Measure (COPM) were considered as primary outcome measurements. Secondary outcomes included total active range of motion (ROM) of the digits, hand grip strength and pinch strengths (tip, palmer and lateral pinch). All measurement was conducted at two occasions: at the baseline and after intervention.

Detailed Description
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The included participant were children with a deep partial thickness or a full thickness burn induced by either a scaled or a flame thermal burn with involvement of more than 50% of the hand and wrist, total body surface area (TBSA) less than 30% , age ranged from 7 to 14 years, recent discharge of inpatient acute care, spontaneous healing (within 34 weeks) or grafting with split thickness or full-thickness skin grafts (at least before 2 weeks). Children were excluded from this study if they had infection, juvenile arthritis, fracture, tendon injuries, muscle injury, degenerative joint diseases, peripheral nerve diseases, Pre - established psychologically and physically disorders (extreme aphasia, cognitive and developmental deficits that can influence the rehabilitation).

Official Title
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Effect of Task Oriented Training and Xbox KinectTM on Hand Function in Pediatric Burn

Conditions
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Burns, Hand Burn

Intervention / Treatment
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* Other: control
* Other: Xbox kinect
* Other: task oriented training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children with deep partial thickness or a full thickness burn burn induced by either a scaled or a flame thermal burn involvement of more than 50% of the hand and wrist total body surface area (TBSA) less than 30% age ranged from 7 to 14 years recent discharge of inpatient acute care spontaneous healing (within 34 weeks) grafting with split thickness or full-thickness skin grafts (at least before 2 weeks). Exclusion Criteria: children with infection juvenile arthritis fracture tendon injuries muscle injury degenerative joint diseases peripheral nerve diseases Pre - established psychologically and physically disorders extreme aphasia cognitive and developmental deficits that can influence the rehabilitation

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 14 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: Task-oriented training TOT group and Xbox training group were conducted with an average of 50-min sessions three times a week for 8 weeks. The traditional rehabilitation program conducted for 40-min sessions, three times per week for 8 weeks for all children.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: control<br>The traditional rehabilitation program conducted for 40-min sessions, three times per week for 8 weeks for all children. | Other: control<br>* The traditional therapy included immersing the hand in paraffin for 10 min; soft massaging with a moisturizing gel for 5 min; passive mobilization of the wrist, MP, PIP, and DIP joints; active/passive ROM and stretching exercises; strengthening exercises (done in static mode initially and progressed in the second month to dynamic strengthening using elastic bands); desensitizing sensory stimulation of hypertrophic scars, occupational therapy.<br>|
| Experimental: task oriented training<br>Task-oriented training TOT group was conducted with an average of 50-min sessions three times a week for 8 weeks. Baseline Canadian Occupational Performance Measure COPM results were used to generate individualized intervention goals for each participant. | Other: control<br>* The traditional therapy included immersing the hand in paraffin for 10 min; soft massaging with a moisturizing gel for 5 min; passive mobilization of the wrist, MP, PIP, and DIP joints; active/passive ROM and stretching exercises; strengthening exercises (done in static mode initially and progressed in the second month to dynamic strengthening using elastic bands); desensitizing sensory stimulation of hypertrophic scars, occupational therapy.<br>Other: task oriented training<br>* The traditional plus the target activities involved training with the materials (clothes, spoons, pencils, buttons, rope, etc) needed for the activity as well as Velcro cylinders, skill cubes, exercise bands, screw sets, therapeutic putty, and tripled coordination tools.<br>|
| Experimental: Xbox kinect<br>Xbox training group was conducted with an average of 50-min sessions three times a week for 8 weeks. Baseline Canadian Occupational Performance Measure COPM results were used to generate individualized intervention goals for each participant. | Other: control<br>* The traditional therapy included immersing the hand in paraffin for 10 min; soft massaging with a moisturizing gel for 5 min; passive mobilization of the wrist, MP, PIP, and DIP joints; active/passive ROM and stretching exercises; strengthening exercises (done in static mode initially and progressed in the second month to dynamic strengthening using elastic bands); desensitizing sensory stimulation of hypertrophic scars, occupational therapy.<br>Other: Xbox kinect<br>* The traditional plus Xbox Kinect games were related to five target activities determined according to the person-centered analysis results were chosen for each patient.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Jebsen-Taylor Hand Function Test | is an objective and standard method designed to assess the hand's functional abilities | baseline | 
| Jebsen-Taylor Hand Function Test | is an objective and standard method designed to assess the hand's functional abilities | immediately after the intervention | 
| Duruoz Hand Index | is a self-reported questionnaire developed to assess hand ability in the kitchen, during dressing, while performing personal hygiene and office tasks, and other general items | baseline | 
| Duruoz Hand Index | is a self-reported questionnaire developed to assess hand ability in the kitchen, during dressing, while performing personal hygiene and office tasks, and other general items | immediately after the intervention | 
| Canadian Occupational Performance Measure | is a client centered, occupation-focused outcome measure for the detection of change in perceived occupational performance over time. | baseline | 
| Canadian Occupational Performance Measure | is a client centered, occupation-focused outcome measure for the detection of change in perceived occupational performance over time. | immediately after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total active range of motion (ROM) of the digits | The total active ROM was measured by a hand-held steel finger goniometer | baseline | 
| total active range of motion (ROM) of the digits | The total active ROM was measured by a hand-held steel finger goniometer | immediately after the intervention | 
| hand grip strength | Grip strength was assessed using a Jamar hydraulic dynamometer | baseline | 
| hand grip strength | Grip strength was assessed using a Jamar hydraulic dynamometer | immediately after the intervention | 
| pinch strength | pinch strengths (tip, palmer and lateral pinch) were assessed using a pinch dynamometer | baseline | 
| pinch strength | pinch strengths (tip, palmer and lateral pinch) were assessed using a pinch dynamometer | immediately after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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children burns, Hand Function, Grip strength, pinch strength, Jebsen-Taylor Hand Function Test, Duruoz Hand Index, Canadian Occupational Performance Measure