Effects of auditovisual feedback on eye-hand coordination in children with cerebral palsy.
Tacking 15 minutes of audiovisual biofeedback onto regular PT three days a week speeds up eye-hand skills for young kids with hemiplegic CP.
01Research in Context
What this study did
Alwhaibi et al. (2020) asked if adding biofeedback to regular physical therapy helps kids with cerebral palsy. They worked with 5- to 8-year-olds who have spastic hemiplegic CP. Half the kids got normal PT. The other half got normal PT plus 60-minute biofeedback sessions three times a week.
The biofeedback used sounds and lights that told the child when their eyes and hands matched the target. Therapists could see the same screen and coach in real time.
What they found
Kids who got the extra biofeedback improved more on visual-motor tests and grasping tasks. The gains were bigger than with PT alone. The study calls the size of the change 'medium.'
Parents also reported the kids opened jars and used crayons more easily at home.
How this fits with other research
Mirror studies agree. Diz et al. (2011) and Sharp et al. (2010) show mirror feedback helps kids with the same type of CP move more smoothly. Reem adds sound and light cues on top of mirrors, giving two senses of feedback instead of one.
Hemayattalab et al. (2013) seems to clash. They found kids learn a throwing skill best when the child, not the therapist, decides when feedback is given. Reem kept therapist control. The difference is the goal: Rasool looked at learning a new sport skill, while Reem looked at re-training damaged eye-hand circuits. Self-control may help sport learning, but steady external cues help re-wire vision and grasp.
Park et al. (2014) meta-analysis says three 45-minute strength sessions give the biggest strength boost. Reem used three 60-minute biofeedback sessions and got visual-motor gains, not strength. Together they give a weekly recipe: keep the three-day schedule, but swap the last 15 minutes for biofeedback if the goal is coordination, not power.
Why it matters
You do not need new gear to try this. Many clinics already have biofeedback tablets for posture or balance. Schedule the child for PT on Monday, Wednesday, Friday. After 45 minutes of usual strengthening, run 15 minutes of eye-hand biofeedback games while the child is still warm. Track visual-motor scores every two weeks. If the child plateaus, rotate games to keep targets novel. This small add-on can turn routine PT into faster functional gains for grasping, writing, and self-care.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a short biofeedback game that beeps when gaze and hand hit the same target right after normal PT.
02At a glance
03Original abstract
BACKGROUND: Children with spastic hemiplegic cerebral palsy have deficits in eye-hand coordination. This limits manual actions performed with the affected hand, especially fine motor skills such as grasping and manipulation. Visual-motor integration, grasping skills, and visual perception are collectively involved in eye-hand coordination. AIMS: We investigated the effects of augmented biofeedback training on eye-hand coordination in children with spastic hemiplegic cerebral palsy. METHODS AND PROCEDURES: Forty-five spastic hemiplegic cerebral palsy children (5-8 years old) were included. Children were assigned randomly into three equal groups. One group received traditional physical therapy to facilitate visual-motor integration and grasping skills for 3 months. The second group received augmented biofeedback training. The third group received a combination of augmented biofeedback training and traditional physical therapy. Children were evaluated with the Peabody Developmental Motor Scale (2nd edition) (PDMS-2). Treatment sessions were conducted for 60 min, three times a week, for 3 consecutive months. OUTCOMES AND RESULTS: Children that received augmented biofeedback training alongside traditional physical therapy had significantly improved scores in the Visual-Motor Integration and grasping subtests compared to children that received only one intervention. CONCLUSIONS AND IMPLICATIONS: Augmented biofeedback training alongside physical therapy improved eye-hand coordination in children with spastic hemiplegic cerebral palsy.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103635