The reliability of upper limb kinematics in children with hemiplegic cerebral palsy
Ellen Jaspers1, Hilde Feys, Herman Bruyninckx
1Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium. ellen.jaspers@faber.kuleuven.be
Insights
This study validates a reliable upper limb three-dimensional movement analysis (UL-3DMA) protocol for children with hemiplegic cerebral palsy (HCP). The UL-3DMA accurately quantifies movement duration, speed, and joint angles, aiding clinical applications.
Area of Science:
- Biomedical Engineering
- Rehabilitation Science
- Pediatric Neurology
Background:
- Hemiplegic cerebral palsy (HCP) significantly impacts upper limb function in children.
- Accurate and reliable assessment of upper limb movement is crucial for effective intervention.
- Existing movement analysis protocols may not fully capture the specific deficits in HCP.
Purpose of the Study:
- To establish the reliability of a novel upper limb three-dimensional movement analysis (UL-3DMA) protocol for children with HCP.
- To assess the consistency of measurements within and between testing sessions.
- To determine the clinical utility of the UL-3DMA for quantifying upper limb kinematics.
Main Methods:
- A standardized UL-3DMA protocol based on ISB recommendations was developed, including reach, reach-to-grasp, and gross motor tasks.
- Twelve children with HCP (aged 6-15 years) participated in reliability testing.
- Intraclass correlation coefficient (ICC) and coefficient of multiple correlation (CMC) were used to assess reliability of movement parameters and waveforms, respectively. Measurement errors were calculated.
Main Results:
- The UL-3DMA demonstrated good within- and between-session reliability for movement duration and speed.
- Joint angles at movement endpoint (trunk, scapula, shoulder, elbow, wrist) showed moderate to very high reliability.
- High reliability was observed for scapula, shoulder, and elbow waveforms, with lower reliability for wrist and trunk. Measurement errors were generally below 5° and 7°.
Conclusions:
- The proposed UL-3DMA protocol is a reliable tool for quantifying upper limb movements in children with HCP.
- The protocol provides a solid foundation for clinical application in assessing and monitoring HCP-related motor deficits.
- Further research is warranted to evaluate the discriminative ability of the UL-3DMA in distinguishing different severities of HCP.
Abstract:
This study describes the reliability of a protocol for upper limb three-dimensional movement analysis (UL-3DMA) in children with hemiplegic cerebral palsy (HCP). The UL-3DMA is based on the ISB-recommendations, and contains a set of functional and clinically relevant tasks. Tasks were selected to reflect the characteristic movement deficits seen in children with HCP. The protocol consists of three reach tasks (forwards, upwards, sideways); two reach-to-grasp tasks (with objects requiring different hand orientations); and three gross motor tasks. Within and between session reliability was tested in a group of 12 children with HCP, aged 6-15 years. Reliability of movement duration/speed and joint angles at endpoint was assessed with the intraclass correlation coefficient; similarity of the waveforms with the coefficient of multiple correlation. Measurement errors were calculated for all parameters. Results indicated good within and between session reliability for movement duration/speed. Trunk, scapula, shoulder, elbow and wrist angles at endpoint generally showed moderately high to very high reliability. High levels of reliability were also found for scapula, shoulder and elbow waveforms and lower levels for the wrist and trunk. Within and between session measurement errors were below 5° and 7°, respectively, for most kinematic parameters. Joint angles in the transverse plane, as well as wrist flexion generally showed higher between session errors (7-10°). This study indicates that the proposed protocol is a reliable tool to quantify upper limb movements in children with HCP, providing a sound base for its clinical application. Further research is needed to establish the discriminative ability of the UL-3DMA.
