Cognitive approach to rehabilitation in children with hyperkinetic movement disorders post-DBS

Objective: This proof-of-concept feasibility trial examined the potential of the Cognitive Orientation to daily Occupational Performance (CO-OP) ApproachTM to augment deep brain stimulation (DBS) outcomes in childhood-onset hyperkinetic movement disorders (HMD) including dystonia and dyskinetic cerebral palsy. Methods: Single case experimental design using multiple baseline as N-of-1 trial comprised of 10 intervention sessions, with replications across participants (n=10). Treatment focused on three participant-selected goals. Transfer was assessed on two additional untreated goals. Individuals enrolled were 6-21 years of age, had DBS in situ and sufficient manual ability. Primary outcome was functional performance change on the Performance Quality Rating Scale-Individualized (PQRS-i) measured before, during, post-treatment, and at 3-months follow-up. Assessors of outcome were blinded to time of assessment, number of intervention session and treatment allocation. To measure effect size,...