The Application Of Remodeled Glove Puppetry For Children With Developmental Disabilities: A Randomized Trial

Objective: To study the improvement of hand performance and play behavior in children with developmental disabilities using remodeled glove puppetry. Method: A pretest-posttest design was used in this randomized controlled trial to evaluate the intervention. Sixty-two children with developmental disabilities were randomly divided into experimental and control groups (n=31 each). Both groups underwent puppet play sessions once daily in playrooms. The children in the experimental group underwent rehabilitation by playing with the remodeled glove puppetry for 12 weeks, while the children in the control group played with non-remodeled glove puppetry. The Chinese puppet was remodeled using the Lego EV3® robot. We analyzed the motion kinematics of the hand using Siliconcoach® Pro 7 software and measured the force produced by the Baseline® hydraulic pinch gauge. The revised Knox Preschool Play Scale was used to score the play behavior. Results: : The significant differences in posttest outcomes between control and experimental groups were hand kinematics (wrist ROM, F = 6.91, p = 0.011; MP ROM, F = 6.66, p = 0.012; PIP ROM, F = 13.16, p = 0.001) and play scales (space management, F = 8.98, p = 0.004; material management, F = 10.04, p = 0.002; pretense-symbolic, F = 9.39, p = 0.003; participation, F = 25.17, p = 0.000). Significant improvement was observed in most of the kinematics and play scores ( p < 0.05) after rehabilitation with remodeled glove puppetry. Conclusion: Further studies using remodeled glove puppetry to improve the range of motion, material management and participation of play quality are useful and needed.