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Real world walking activity in children with myelomeningocele

tal treatment. The intervention is a perceptual-learning approach to improving somatosensory discrimination, particularly tactile discrimination, haptic object recognition and proprioception. All participants were assessed using the SENSe Assess Kids at baseline and 6 weeks later. The sense_assess for kids consists of the Wrist Position Sense Test; Tactile Discrimination Test; and the functional Tactile Object Recognition Test. In addition the box and blocks test, Goal Attainment Scaling (GAS) and the Canadian Occupational Performance Measure (COPM) were used to monitor activity and participation. Results: Each child’s individual change from baseline to 6 weeks was calculated and expressed as a percentage. The treatment group demonstrated an improvement in wrist position sense score with a reduction in average error score (median 5.6) and the control group showed no change (median 0.0). The treatment group demonstrated an improvement in their object recognition score (M 12.9, SD 17.5) while there was no observed change for the control group (M 2.7, SD 33.1). The treatment group showed greater improvement in their scores in the box and blocks test (M 15.0, SD 65.0) than the control (M 9.7, SD 47.1). Based on the small number of participants, differences were not significantly different between groups. The treatment group set 17 goals using GAS and 13 of these achieved expected or greater than expected outcome, while none of the 12 goals set by the control group were achieved. Conclusions/Significance: We observed improvement in somatosensory discrimination in the treatment group. This improvement was not statistically significant but this is to be expected with small numbers. A high proportion of children in the treatment group also improved their gross grasp and achieved the goals they had set compared with the control group. These data provide sufficient evidence to support further exploration of sensory discrimination training for children with HCP.