A new child-friendly 3D bimanual protocol to assess upper limb movement in children with unilateral cerebral palsy:
Marine Cacioppo1, Antoine Marin2, Hélène Rauscent3
1Department of Physical Medicine and Rehabilitation, Rennes University Hospital, 35033 Rennes, France; Pediatric Rehabilitation Department, Fondation Ildys, Ty Yann, 29200 Brest, France; Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université de Bretagne-Occidentale, 29200 Brest, France; Department of Physical Medicine and Rehabilitation, Brest University Hospital, 29200 Brest, France.
Insights
This study validates a new 3D bimanual movement analysis protocol for children with unilateral cerebral palsy (uCP). The protocol accurately assesses upper limb function, aiding in understanding movement disorders and optimizing treatment.
Area of Science:
- Rehabilitation Medicine
- Biomedical Engineering
- Pediatric Neurology
Background:
- Unilateral cerebral palsy (uCP) significantly impairs upper limb function, particularly in bimanual tasks, affecting daily activities.
- Objective 3D motion analysis of bimanual tasks in children with uCP is limited.
- Existing methods may not be sufficiently child-friendly or comprehensive for assessing nuanced movement patterns.
Purpose of the Study:
- To validate a novel, child-friendly, 3D bimanual protocol for measuring joint angles and movement quality in children.
- To assess the reliability and validity of this protocol in children with and without uCP.
- To provide an objective tool for evaluating upper limb bimanual function in pediatric populations.
Main Methods:
- A cohort of 20 children with uCP and 20 typically developing children (TDC) participated.
- Participants performed a five-task, 3D bimanual protocol integrated into a game.
- Kinematic variables including joint angles, smoothness, and trajectory straightness were calculated and analyzed.
Main Results:
- Children with uCP exhibited reduced joint angle amplitudes (elbow extension, supination, wrist extension/adduction) and less smooth, straighter hand trajectories compared to TDC.
- Strong correlations were observed between performance-based scores and kinematic variables.
- The protocol demonstrated high within- and between-session reliability for most joint angle measures, with lower reliability for smoothness and straightness.
Conclusions:
- The validated 3D bimanual protocol is a reliable and valid tool for the objective assessment of upper limb function in children with uCP.
- Evaluating both joint angles and movement quality provides deeper insights into pathological movement.
- This assessment method can aid clinicians in optimizing treatment strategies for children with uCP.
Abstract:
Unilateral cerebral palsy (uCP) causes upper limb movement disorders that impact on daily activities, especially in bimanual condition. However, a few studies have proposed bimanual tasks for 3D motion analysis. The aim of this study was to validate the new version of a child-friendly, 3D, bimanual protocol for the measurement of joint angles and movement quality variables. Twenty children with uCP and 20 typically developing children (TDC) performed the five-task protocol integrated into a game scenario. Each task specifically targeted one or two upper limb degrees of freedom. Joint angles, smoothness and trajectory straightness were calculated. Elbow extension, supination, wrist extension and adduction amplitudes were reduced; hand trajectories were less smooth and straight in children with uCP compared to TDC. Correlations between the performance-based score and kinematic variables were strong. High within and between-session reliability was found for most joint angle variables and lower reliability was found for smoothness and straightness in most tasks. The results therefore demonstrated the validity and reliability of the new protocol for the objective assessment of bimanual function in children with uCP. The evaluation of both joint angles and movement quality variables should increase understanding of pathological movement patterns and help clinicians to optimize treatment. ClinicalTrials.gov identifier: NCT03888443.
