Occupational Therapy

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Browsing Occupational Therapy by Author "Bence, Jenine"

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    The effect of integration of the fear paralysis reflex on the occupational performance of children referred with handwriting problems
    (Stellenbosch : Stellenbosch University, 2024-03) Bence, Jenine; Sheik Ismail, Arifa; Plastow, Nicola Ann; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Background: Unintegrated primary reflexes and subsequent delayed cortical maturation leads to behavioural and learning problems in childhood and throughout the lifespan. Rhythmic Movements from Rhythmic Movement Training International (RMTi) significantly improved the integration of the Fear Paralysis reflex and lead to significant improvements in occupational performance of children. RMTi Rhythmic Movement Training is used by few occupational therapists in few countries. No evidence to demonstrate the effectiveness of the Fear Paralysis reflex integration nor research on the Fear Paralysis reflex per se were found. Method/design: This randomised clinical trial evaluated the change in occupational performance from the child’s perspective using the Canadian Occupational Performance Measure after 6 hours of RMTi Fear Paralysis reflex integration. A time series crossover with random allocation and delayed treatment period 2, and a pre- to post-study design, was used. Participants included 14 children aged 8-9 years referred with handwriting problems, attending four public schools in Cape Town, South Africa. Repeated Canadian Occupational Performance Measure assessment was at baseline test 1 and 2, mid-intervention test 3, two weeks post intervention test 4 and at 12 to 15 weeks post intervention test 5. Pre- and post-assessments included the RMTi and Masgutova Neuro-sensory-motor Reflex Integration® (MNRI®) Fear Paralysis reflex assessments, the Short Sensory Profile sensory processing, the Interactive Metronome® neuro-timing, and the Systematic Detection of Handwriting (SOS-2-EN) problems. Intervention included eight, weekly individual RMTi Fear Paralysis reflex integration sessions with an occupational therapist, and a carer led RMTi Home Support Fear Paralysis reflex programme 3 to 4 times per week. The caregivers were usually present during the assessment and intervention sessions. Those caregivers who could comply, experienced the 4 RMTi Home Support Fear Paralysis reflex integration movements before demonstrating these on their child. Findings: RMTi Fear Paralysis reflex intervention statistically significantly improved the Fear Paralysis reflex integration (p=0.003), sensory processing (p=0.025) and handwriting speed (p=0.001). Handwriting quality and neuro-timing did not improve. Within participant repeated measures analysis showed that the RMTi Fear Paralysis reflex intervention statistically significantly improved the occupational performance of participants, from the child’s perspective and from the caregivers’ perspective. Children statistically significantly improved in their performance (p=0.002) of a range of occupations that they identified as important and increased statistically significantly in satisfaction (p=0.01) with their performance. Similarly, the caregivers’ ratings of performance (p=0.007) and satisfaction (p=0.01) for occupational performance problems they observed in their children, also statistically significantly improved. Results were clinically and statistically significant. Discussion: All 14 participant children presented with an unintegrated Fear Paralysis reflex, lack of sensory integration, low levels of performance and satisfaction in daily activities, and poor handwriting, pre-intervention. Fear Paralysis reflex integration could shorten the therapy period needed to improve occupational performance including handwriting. Caregiver involvement in RMTi Home Support under guidance of therapists could promote parent empowerment in fostering development of their child.