Proposal of a new 3D bimanual protocol for children with unilateral cerebral palsy: Reliability in typically
Brice Bouvier1, Florence Gaillard2, Guillaume Bouzillé3
1Univ Rennes, M2S - EA 7470, F-35000 Rennes, France.
Insights
A new 3D bimanual protocol, "Be an Airplane Pilot" (BE-API), shows high reliability for assessing upper limb (UL) movement in children. This reliable protocol can aid in evaluating treatments for children with unilateral cerebral palsy (uCP).
Area of Science:
- Pediatric Rehabilitation
- Biomechanics
- Neuroscience
Background:
- Quantitative assessment of upper limb (UL) kinematics in children with unilateral cerebral palsy (uCP) is complex, particularly during bimanual tasks.
- Existing methods pose challenges for researchers and clinicians in accurately measuring UL movement in this population.
- A novel, specialized 3D bimanual protocol is needed to address these evaluation difficulties.
Purpose of the Study:
- To introduce and evaluate the reliability of a new 3D bimanual protocol, the "Be an Airplane Pilot" (BE-API) protocol.
- To assess the protocol's suitability for children with uCP by testing its reliability in typically developing children (TDC).
- To provide a reliable tool for quantitative kinematic analysis of the UL in pediatric populations.
Main Methods:
- The BE-API protocol comprises four distinct bimanual tasks designed to capture all degrees of freedom of the hemiplegic/non-dominant UL.
- Twenty typically developing children (TDC) participated in three separate protocol sessions to ensure consistent measurement.
- Reliability was quantified using three kinematic parameters: angular waveforms (WAVE) via the coefficient of multiple correlation (CMC), and range of motion (RoM) and maximum angles (MAX) via the intra-class correlation coefficient (ICC) and standard error of measurement (SEM).
Main Results:
- The BE-API protocol demonstrated very good reliability across the evaluated kinematic parameters.
- Specifically, angular waveforms (WAVE) showed high reliability with CMC values ≥0.90.
- Range of motion (RoM) and maximum angles (MAX) also exhibited excellent reliability, with ICC values ≥0.81 and SEM values ≤5.0°.
Conclusions:
- The high reliability of the BE-API protocol is attributed to its rigorous design and execution.
- These findings support the protocol's potential for use in clinical settings with children with uCP.
- The BE-API protocol shows promise for objectively assessing therapeutic interventions, such as botulinic toxin injections, to guide clinical decisions.
Introduction:
Quantitative evaluation of upper limb (UL) kinematics in children with unilateral cerebral palsy (uCP) remains challenging for researchers and clinicians, especially during bimanual situations. This study proposed a new 3D bimanual protocol dedicated to children with uCP, called "Be an Airplane Pilot" (BE-API protocol) and assessed its reliability for typically developing children (TDC).
Methods:
this protocol is composed of four bimanual tasks that allow the exploration of all degrees of freedom of the hemiplegic/non-dominant UL. Twenty TDC (mean age 11.9 ± 3.4) carried out three protocol sessions. Reliability was investigated through three kinematic parameters: angular waveforms (WAVE) using the coefficient of multiple correlation (CMC), range of motion (RoM) and maximum angles (MAX) both using the intra-class correlation coefficient (ICC) and the standard error of measurement (SEM).
Results:
A very good reliability was observed for the three kinematic parameters in most cases (WAVE: CMC ≥0.90, RoM & MAX: ICC ≥0.81, SEM ≤5.0°).
Discussion:
the very good reliability can be partly explained by the high level of rigor of the protocol. Such promising results open the door to validation tests on children with uCP. The BE-API protocol could pretend to support clinical decisions by objectively assessing the efficiency of therapeutics, e.g. injection of botulinic toxin.
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