A Holistic Approach Towards Evaluating Upper Limb Function in Children with Unilateral Cerebral Palsy: A Narrative
Giovanna De Luca1,2, Alexandra Kalkantzi3,4, Lisa Mailleux3,4
1The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025 Pisa, Italy.
Insights
Children with unilateral spastic cerebral palsy (USCP) often have upper limb (UpL) impairments. This study reviews tools and novel technologies for a holistic UpL evaluation, considering non-motor functions for better daily life assessments.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Biomedical engineering
Background:
- Optimal upper limb (UpL) function is crucial for daily activities, but children with unilateral spastic cerebral palsy (USCP) often exhibit significant impairments.
- Non-motor deficits (cognition, attention, visual function) are common in USCP and can affect UpL performance, yet are often overlooked in standard evaluations.
- Traditional clinical assessments in controlled settings may not fully represent a child's functional abilities in real-world environments.
Purpose of the Study:
- To present frequently used tools for a holistic evaluation of UpL function in children with USCP.
- To review evidence on how novel, non-invasive technologies can improve clinical evaluations by providing quantitative and ecologically valid data.
- To advocate for multidimensional evaluation protocols that incorporate both motor and non-motor functions for a comprehensive understanding of UpL function in USCP.
Main Methods:
- Literature review of existing evaluation tools for USCP.
- Synthesis of evidence on the application of novel non-invasive technologies in assessing UpL function.
- Analysis of the role of non-motor functions in UpL performance in children with USCP.
Main Results:
- Identification of key tools for holistic UpL assessment in USCP.
- Demonstration of the potential of novel technologies to enhance ecological validity and quantitative data in clinical evaluations.
- Highlighting the significant impact of non-motor functions on UpL performance, often underestimated in current practices.
Conclusions:
- A multidimensional approach integrating motor and non-motor assessments is essential for a comprehensive understanding of UpL function in USCP.
- Novel non-invasive technologies offer promising avenues for more accurate, ecologically valid, and quantitative evaluations in daily life settings.
- This work provides a foundation for developing advanced evaluation protocols that move beyond traditional methods to better support children with USCP.
Abstract:
Optimal upper limb (UpL) function is essential for performing daily activities; however, children with unilateral spastic cerebral palsy (USCP) often experience impairments in UpL function, which can impact their quality of life or independence. While UpL motor impairments are a primary concern, non-motor functions, such as cognition, attention, and visual function, commonly impaired in USCP, may also play a role in UpL performance. Nevertheless, these non-motor functions are often not considered in evaluation protocols that focus on the UpL. Moreover, clinical evaluation is typically conducted in structured and controlled settings and may not accurately reflect the child's abilities in daily life. Non-invasive, novel technologies are a promising solution for filling this gap, by providing additional quantitative and ecologically valid information to clinicians. In this context, this overview aims (i) to present the most frequently used tools for a holistic evaluation in children with USCP, ensuring a thorough understanding of the UpL function, and (ii) to report the evidence of how novel, non-invasive technologies can enhance clinical evaluation in daily life, enabling a more comprehensive evaluation. This work could set a basis for multidimensional evaluation protocols for UpL function in USCP, providing a different approach to the current standards.
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