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A Method for Quantifying Upper Limb Performance in Daily Life Using Accelerometers
Published on: April 21, 2017
Wearable sensors for measuring spontaneous upper limb use in children with unilateral cerebral palsy and typical
Elena Beani1,2, Mattia Franchi de 'Cavalieri2,3, Silvia Filogna4
1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Insights
Wearable sensors effectively monitor upper limb (UpL) use in children with Unilateral Cerebral Palsy (UCP). This technology reveals distinct daily UpL usage patterns compared to typically developing peers, correlating with clinical assessments.
Area of Science:
- Biomedical Engineering
- Rehabilitation Technology
- Pediatric Neurology
Background:
- Unilateral Cerebral Palsy (UCP) affects movement and muscle tone on one side of the body, impacting manual function.
- Assessing Upper Limb (UpL) use and asymmetry in daily life offers deeper insights than clinical tests alone.
- Wearable sensors provide a non-invasive method for continuous monitoring of UpL function.
Purpose of the Study:
- To compare spontaneous daily UpL usage and asymmetry in children with UCP versus typically developing (TD) peers using wearable sensors.
- To correlate wearable sensor data of UpL usage and asymmetry with the Assisting Hand Assessment (AHA) test results.
Main Methods:
- Eighty children (54 UCP, 26 TD) wore wrist-worn Actigraph sensors during the AHA test and for one week of daily life.
- Analysis of hand use amount and asymmetry during both structured testing and daily activities.
- Statistical analysis using linear regression and ANOVA models to compare groups and correlate measures.
Main Results:
- Significant correlations were found between weekly asymmetry, AHA scores, and test-day asymmetry.
- Distinct differences in weekly asymmetry distribution were observed between UCP and TD children.
- Variations in UpL usage patterns were noted when UCP children were grouped by Manual Ability Classification System (MACS) levels.
Conclusions:
- Wearable sensors offer a novel, user-friendly method for monitoring UpL behavior in real-world settings.
- Data confirms a linear relationship between asymmetry measured in assessments and daily life.
- This study provides evidence of differing UpL usage patterns between children with UCP and their TD peers during everyday activities.
Background:
Unilateral Cerebral Palsy (UCP) is a clinical condition which mainly involves the movement and muscle tone of one side of the body, often impacting the general manual function. While there are some clinical assessment tools aimed to quantify the Upper Limbs (UpLs) use and the manual abilities, acquiring information regarding the motor abilities outside the clinical environment, such as the UpLs use and their asymmetry during daily life, could provide a more complete evaluation of the child and open a new clinical reasoning. For this purpose, wearable sensors are one of the newest approaches for continuously monitoring UpLs functions without being invasive. The aim of this study was to use wearable sensors to compare spontaneous/daily UpLs usage and asymmetry with the Assisting Hand Assessment (AHA) test, as well as comparing the daily UpLs usage behavior of children with UCP with respect to Typical Developing (TD) peers.
Methods:
Eighty children (54 with UCP and 26 TD) wore an Actigraph sensor on each wrist during the AHA test and then at least for the following week of daily life. The amount of use of each hand and the asymmetry were analyzed during both the AHA and the following week of daily life using linear regression analysis and ANOVA models.
Results:
Significant relationships were found between the asymmetry detected during the week and both the AHA scores and the asymmetry detected during the test. UCP and TD children week asymmetry distributions were significantly different; moreover, some differences were found when grouping them by MACS levels.
Conclusion:
This paper proposes a new and easy technological methodology for monitoring UpLs behavior in daily life. Through wearable sensor data analysis, we demonstrate a linear correlation between asymmetry measured during smi-structured assessments and daily life. Additionally, we provide evidence of distinct patterns of UpLs usage between typically developing children and children with UCP in daily life.
Trial Registration:
Clinical Trials.gov (NCT03054441).
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