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Published on: April 21, 2017
Bilateral actigraphic quantification of upper extremity movement in hemiparetic children with perinatal stroke: a
Asha Hollis1,2, Lauran Cole1,2, Ephrem Zewdie1,3
1Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Insights
Bilateral actigraphy effectively measures upper extremity movement asymmetry in children with hemiparetic cerebral palsy. This method offers a valuable complement to standard tests for assessing daily arm function and therapy outcomes.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Hemiparetic cerebral palsy affects millions globally, presenting significant challenges in assessing real-world bilateral motor function.
- Current assessment methods may not fully capture the extent of upper extremity movement asymmetry in daily life.
- Objective quantification of motor function is crucial for effective intervention and rehabilitation.
Purpose of the Study:
- To evaluate the utility of bilateral actigraphy for quantifying upper extremity movement asymmetry in children with hemiparetic cerebral palsy.
- To investigate the correlation between actigraphy-derived movement asymmetry and established clinical motor outcome measures.
- To determine if actigraphy provides a more comprehensive assessment of daily arm function compared to standard tests.
Main Methods:
- Bilateral wrist actigraphy (Actiwatch2) was used to record movement in 30 children with hemiparetic cerebral palsy and 23 controls over 48 hours.
- The primary outcome measure was the Actigraphic Movement Asymmetry Index (AMAI), a novel statistic quantifying movement asymmetry.
- Correlations between AMAI and standard motor assessments (Assisting Hand Assessment, Melbourne Assessment, Box and Block Test) were analyzed.
Main Results:
- Children with hemiparetic cerebral palsy exhibited significantly higher movement asymmetry compared to controls.
- Moderate correlations were observed between AMAI and standard motor outcome measures.
- The strongest correlation between AMAI and the Box and Block Test was found during sleep (r=0.68, p<0.01).
Conclusions:
- Bilateral actigraphy is a valuable tool for assessing upper extremity movement asymmetry in hemiparetic cerebral palsy during daily activities.
- Actigraphy may offer a more sensitive measure of functional arm use than traditional clinical assessments.
- This technology can potentially enhance the evaluation of therapies focused on improving child participation and daily function.
Background:
Hemiparetic cerebral palsy impacts millions of people worldwide. Assessment of bilateral motor function in real life remains a major challenge. We evaluated quantification of upper extremity movement in hemiparetic children using bilateral actigraphy. We hypothesized that movement asymmetry correlates with standard motor outcome measures.
Methods:
Hemiparetic and control participants wore bilateral wrist Actiwatch2 (Philips) for 48 h with movement counts recorded in 15-s intervals. The primary outcome was a novel statistic of movement asymmetry, the Actigraphic Movement Asymmetry Index (AMAI). Relationships between AMAI and standard motor outcomes (Assisting Hand Assessment, Melbourne Assessment, and Box and Block Test [BB]) were explored with Pearson or Spearman correlation.
Results:
30 stroke (mean 11 years 2 months (3 years 10 months); 13 female, 17 male) and 23 control (mean 11 years 1 month (4 years 5 months); 8 female, 15 male) were enrolled. Stroke participants demonstrated higher asymmetry. Correlations between AMAI and standard tests were moderate and strongest during sleep (BB: r = 0.68, p < 0.01).
Conclusions:
Standard tests may not reflect the extent of movement asymmetry during daily life in hemiparetic children. Bilateral actigraphy may be a valuable complementary tool for measuring arm movement, potentially enabling improved evaluation of therapies with a focus on child participation.
