Robotic assessment of rapid motor decision making in children with perinatal stroke
Rachel L Hawe1, Andrea M Kuczynski2, Adam Kirton3,4,5
1Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada. Rachel.hawe@ucalgary.ca.
Insights
Children with hemiparetic cerebral palsy show impaired rapid motor decision-making and inhibitory control. Targeted therapies addressing both motor and executive functions are crucial for improving daily living activities.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Neuroscience
Background:
- Hemiparetic cerebral palsy (CP) in children, often resulting from perinatal stroke, can involve executive function deficits alongside motor impairments.
- Daily activities necessitate rapid decision-making, motor execution, and inhibition of unwanted actions.
Purpose of the Study:
- To assess rapid motor decision-making in children with hemiparetic CP using a robotic object hit and avoid task.
- To investigate inhibitory control abilities in this population.
Main Methods:
- A robotic object hit and avoid task was administered using the Kinarm Exoskeleton to 45 children with hemiparetic CP and 146 typically developing children (ages 6-19).
- Participants were instructed to hit target shapes while avoiding distractor shapes presented at increasing speeds and frequencies.
- Performance was compared between groups, accounting for age, and contrasted with a simpler object hit task without distractors.
Main Results:
- Children with hemiparetic CP hit a significantly higher proportion of distractors, indicating impaired inhibitory control.
- Performance in all children improved with age.
- Children with hemiparetic CP showed a greater improvement in target accuracy on the complex task compared to a simpler task, unlike typically developing children.
Conclusions:
- Children with hemiparetic CP exhibit deficits in rapid motor decision-making and inhibitory control, impacting real-world task performance.
- Therapeutic interventions should integrate motor performance and executive function training to enhance overall function in children with hemiparetic CP.
Background:
Activities of daily living frequently require children to make rapid decisions and execute desired motor actions while inhibiting unwanted actions. Children with hemiparetic cerebral palsy due to perinatal stroke may have deficits in executive functioning in addition to motor impairments. The objective of this study was to use a robotic object hit and avoid task to assess the ability of children with hemiparetic cerebral palsy to make rapid motor decisions.
Methods:
Forty-five children with hemiparetic cerebral palsy due to perinatal stroke and 146 typically developing children (both groups ages 6-19 years) completed a robotic object hit and avoid task using the Kinarm Exoskeleton. Objects of different shapes fell from the top of the screen with increasing speed and frequency. Children were instructed to hit two specific target shapes with either hand, while avoiding six distractor shapes. The number of targets and distractors hit were compared between children with hemiparetic cerebral palsy and typically developing children, accounting for age effects. We also compared performance to a simpler object hit task where there were no distractors.
Results:
We found that children with hemiparetic cerebral palsy hit a greater proportion of total distractors compared to typically developing children, demonstrating impairments in inhibitory control. Performance for all children improved with age. Children with hemiparetic cerebral palsy hit a greater percentage of targets with each arm on the more complex object hit and avoid task compared to the simpler object hit task, which was not found in typically developing children.
Conclusions:
Children with hemiparetic cerebral palsy due to perinatal stroke demonstrated impairments in rapid motor decision making including inhibitory control, which can impede their ability to perform real-world tasks. Therapies that address both motor performance and executive functions are necessary to maximize function in children with hemiparetic cerebral palsy.
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