Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Effectiveness of Nintendo Wii Training in Improving the Hand Motor Functions of Children and Adolescents With Cerebral Palsy(2023-04-03) Alhenaky, Malak; Jones, UnaBackground: Cerebral palsy (CP) is one of the leading causes of disability among children. Most children and adolescents with CP have impaired hand motor function, which may significantly affect their functional independence and quality of life. Nintendo Wii is a commercial virtual reality (VR) system that is most widely utilised to improve hand motor function in children and adolescents with CP. Several systematic reviews have assessed the effects of training with various VR systems, which differ considerably in their characteristics, but none have focused on Nintendo Wii training (NWT). Aim: To determine the effectiveness of NWT in improving the hand motor functions of children and adolescents with CP. Methods: A comprehensive search was conducted in the CINAHL, AMED, EMBASE, Ovid Emcare, Medline via Ovid and Scopus databases. Only randomised controlled trials (RCTs) that assessed the effectiveness of NWT alone or in combination with conventional therapy (CT) in improving hand motor function, including manual dexterity, strength and hand grasp, in children and adolescents with CP were selected. Two independent reviewers evaluated the methodological quality of these studies and based on the results of a critical appraisal, chose which studies to include in the review. The quality of the studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. A narrative synthesis was performed to synthesise the data. Results: Five RCTs with a total of 192 participants were included in the review. Three studies were of high quality; the others were of moderate quality. In the included studies, the NWT-CT combination improved grip strength, pinch strength and hand grasp. These improvements were greater than those found with the CT alone. Regarding the effect of NWT on manual dexterity, only the studies that included Tennis and Boxing games showed clinically relevant improvements. Conclusion: Due to the limited number of included studies and their several methodological limitations, insufficient evidence is available to draw definitive conclusions about the effectiveness of NWT in improving the hand motor functions of children and adolescents with CP. Further high-quality studies with larger sample sizes and long-term follow-up are required.17 0Item Restricted Development of a core outcome set for lower limb orthopaedic suregical interventions in ambulant children and young people with cerebral palsy(2023-05-09) Almoajil, Hajar; Dawes, Helen; Toye, Francine; Theologis, Tim; Hopewell, Sally; Saboskbar, AfsieFirst and foremost, I offer my sincerest gratitude to my primary supervisor, Mr. Tim Theologis, for his guidance and support, valuable advice and feedback, for being straight-forward, for not giving up and patiently helping me to stay on the track and unwavering support, in many an hour of self-doubt. I would like to thank him for seeing the potential and believing in me, encouraging me to pursue this body of work. Thank you! I am grateful to my co-supervisors, Professor Helen Dawes, Professor Sally Hopewell and Dr Francine Toye, for offering their expertise, insight, and for their patience, guidance. Thanks must go to Professor Crispin Jenkinson, for his support and contribution and guidance on setting up the project. I am extremely grateful to all advice from members of our Patient and public Involvement group, and the steering committee, ensured that this work focussed on what mattered most to children undergoing lower limb orthopaedic surgery. This project, which I am, always have and always will be passionate about, would not have been possible without the participation of children and young adults with CP, their families and healthcare professionals across the UK and colleagues internationally, who have participated with excitement, wisdom and honesty. I hope that the influences of this research are far-reaching. I am indebted to the Imam Abdulrahman bin Faisal University for funding me to undertake a DPhil program. This decision has made an incredibly positive impact on my life, and I hope, produced work that will benefit children with CP internationally. To my colleagues, Foteini Mavrommati, Stella Koukides, Jerneja Uhan, Norah Almulhem and Wafa Almusallam for their guidance and inspiring me every single time we met through the years in completing this research. I reserve my most heartfelt thanks for my family. My parents and family, for their constant love and support and for believing in me enthusiastically. Most of all, I would like to thank my husband, Abdullah, who has been my biggest supporter, and whose bravery, integrity and resilience are a constant source of inspiration.27 0