Association between upper limb clinical tests and accelerometry metrics for arm use in daily life in children with...

Area of Science:

• Pediatrics
• Neurology
• Rehabilitation Science

Background:

• Unilateral cerebral palsy (CP) significantly impacts upper-limb (UL) function.
• Objective quantification of UL use and asymmetry in daily life is crucial for effective management.
• Current clinical assessments may not fully capture real-world UL performance.

Purpose of the Study:

• To evaluate the association between established UL clinical tests and accelerometry-derived metrics in children with unilateral CP.
• To determine if accelerometry can provide objective, real-world data on UL function and asymmetry.

Main Methods:

• Cross-sectional study including 20 children with unilateral CP (Manual Ability Classification System levels I-III).
• Collected data using the Assisting Hand Assessment, Box and Block Test, and accelerometry during clinical assessments and daily life.
• Analyzed UL asymmetry index and relative UL use across different physical activity levels using Spearman's correlation.

Main Results:

• Strongest negative association found between Assisting Hand Assessment scores and accelerometry during sedentary periods (r_s = -0.64).
• UL asymmetry was significantly higher during sedentary time (45.15) compared to light (23.97) or higher intensity activity (13.39).
• Children utilized both ULs simultaneously for 44% of the time during daily activities.

Conclusions:

• Accelerometry metrics offer valuable, objective data on UL movements and asymmetry in the daily lives of children with unilateral CP.
• These objective measures can supplement traditional clinical tests for a more comprehensive understanding of UL function.
• Findings support the use of accelerometry for monitoring and evaluating interventions in pediatric CP.