1998 Grasp Study – Spastic Cerebral Palsy

The Design

Four children, ages 2 – 3 ½ years old, participated in a 1996 study at the University of Wisconsin, Madison. The 10-week study examined how effective the McKie Thumb Splint was in changing grasp patterns in children with spastic cerebral palsy.

Two of the children had hemiplegic cerebral palsy and two had quadriplegic cerebral palsy. Despite having used other types of splints prior to the study all of the children used abnormal or ineffective types of grasp patterns.

The study was done in natural settings. The children were videotaped twice a week in their day cares or homes while they participated in their regular occupational, physical and/or speech therapy. During the beginning sessions the children did not wear the splint. The splint was then introduced during latter sessions with the families agreeing to have their child wear the splint for 8 hours a day when the child was up and active.

Measurement

Two independent raters reviewed the videotapes using a video-computer hook-up. They rated the grasps using a modified version of the Erhardt Development Prehension Scales. To assure unbiased results, the raters did not know who designed the splint and were in fact told the purpose of the study was to look at the therapeutic effectiveness of the different types of therapists involved in the study.

The Results

The Koehler-Levin procedure, was used to statistically analyze the data. (This statistical tool was chosen because it has the capability of statistically analyzing small sample "multiple baseline" studies). The results were that each child showed a significant improvement in grasp patterns. (p values were between .016 and .005). From a practical point of view, the children were able to do activities they had never done before such as remove marker caps without help or use their two hands together to connect blocks.


Grasp Study Photos

The following photographs were taken in June and August of 1996 and are posted with the permission of the parents.

Each before and after photo shows how the splint improves grasping ability in children.

Puzzle

Before splint is introduced

After splint is introduced


Toy Car

Before splint is introduced

After splint is introduced


Blocks

Before splint is introduced

After splint is introduced