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Updated: Jul 26, 2025
A Method for Quantifying Upper Limb Performance in Daily Life Using Accelerometers
Published on: April 21, 2017
Detecting Asymmetry of Upper Limb Activity with Accelerometry in Infants at Risk for Unilateral Spastic Cerebral
Cornelia H Verhage1, Jan Willem Gorter2, Tim Takken1
1Center for Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Insights
Accelerometry accurately quantifies upper limb asymmetry in infants at risk for unilateral spastic cerebral palsy (USCP). This method aids early detection of asymmetrical hand function from 3 months old.
Area of Science:
- Pediatrics
- Neurology
- Biomedical Engineering
Background:
- Infants with unilateral perinatal brain injury are at high risk for developing unilateral spastic cerebral palsy (USCP).
- Early detection of functional asymmetry is crucial for timely intervention in at-risk infants.
- Quantifying upper limb activity asymmetry can aid in identifying USCP development.
Purpose of the Study:
- To evaluate the efficacy of accelerometry in quantifying upper limb activity asymmetry.
- To determine if accelerometry can detect functional differences in infants at risk for USCP.
- To assess the utility of accelerometry in infants aged 3-12 months.
Main Methods:
- A prospective study involving 50 infants with unilateral perinatal brain injury.
- Triaxial accelerometers were attached to the upper limbs during the Hand Assessment for Infants (HAI).
- Infants were grouped by age (3-5, 5-7.5, 7.5-12 months) and hand function symmetry.
Main Results:
- The asymmetry index for mean upper limb activity was significantly higher in infants with asymmetrical hand function across all age groups (p < 0.01).
- Infants with asymmetrical hand function showed an asymmetry index of 41-51%, compared to -2-6% in those with symmetrical function.
- Total upper limb activity did not differ between infants with symmetrical and asymmetrical hand function.
Conclusions:
- Upper limb accelerometry effectively identifies asymmetrical hand function in infants with unilateral perinatal brain injury from 3 months of age.
- Accelerometry serves as a valuable, complementary tool to the Hand Assessment for Infants (HAI) for USCP risk assessment.
- This technology facilitates objective, quantitative measurement of upper limb asymmetry in early childhood development.
Aims:
To examine whether accelerometry can quantitate asymmetry of upper limb activity in infants aged 3-12 months at risk for developing unilateral spastic cerebral palsy (USCP).
Method:
A prospective study was performed in 50 infants with unilateral perinatal brain injury at high risk of developing USCP. Triaxial accelerometers were worn on the ipsilateral and contralesional upper limb during the Hand Assessment for Infants (HAI). Infants were grouped in three age intervals (3-5 months, 5-7.5 months and 7.5 until 12 months). Each age interval group was divided in a group with and without asymmetrical hand function based on HAI cutoff values suggestive of USCP.
Results:
In a total of 82 assessments, the asymmetry index for mean upper limb activity was higher in infants with asymmetrical hand function compared to infants with symmetrical hand function in all three age groups (ranging from 41 to 51% versus - 2-6%, p < 0.01), while the total activity of both upper limbs did not differ.
Conclusions:
Upper limb accelerometry can identify asymmetrical hand function in the upper limbs in infants with unilateral perinatal brain injury from 3 months onwards and is complementary to the Hand Assessment for Infants.
