The Cerebral Palsy Kinematic Assessment Tool (CPKAT): feasibility testing of a new portable tool for the objective evaluation of upper limb kinematics in children with cerebral palsy in the non-laboratory setting (original) (raw)
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Upper Limb Movement Measurement Systems for Cerebral Palsy: A Systematic Literature Review
Sensors, 2021
Quantifying the quality of upper limb movements is fundamental to the therapeutic process of patients with cerebral palsy (CP). Several clinical methods are currently available to assess the upper limb range of motion (ROM) in children with CP. This paper focuses on identifying and describing available techniques for the quantitative assessment of the upper limb active range of motion (AROM) and kinematics in children with CP. Following the screening and exclusion of articles that did not meet the selection criteria, we analyzed 14 studies involving objective upper extremity assessments of the AROM and kinematics using optoelectronic devices, wearable sensors, and low-cost Kinect sensors in children with CP aged 4–18 years. An increase in the motor function of the upper extremity and an improvement in most of the daily tasks reviewed were reported. In the population of this study, the potential of wearable sensors and the Kinect sensor natural user interface as complementary devices...
Quantification of upper extremity function and range of motion in children with cerebral palsy
Developmental Medicine & Child Neurology, 2008
This study evaluated the hypothesis that upper extremity function and range of motion can be quantified reliably in children with cerebral palsy (CP) in a busy clinical setting. The specific aim was to determine the inter-and intrarater reliability of a modified House Functional Classification (MHC) system to evaluate upper extremity function and a standardized instrument to document upper extremity range of motion (Upper Extremity Rating Scale [UERS]). Sixty-five children with CP (43 males, 22 females, mean age 9y 2mo, SD 4y 1mo) with spasticity involving the upper extremity (quadriplegia n=22; hemiplegia n=36; diplegia n=7; Gross Motor Functional Classification System Levels I n=41, II n=6, III n=3, IV n=5, V n=10) were evaluated independently by occupational therapists and orthopedic surgeons using both instruments at several visits. Inter-and intrarater reliability were determined for both instruments by calculating measures of agreement (weighted kappa values and intraclass correlation coefficients [ICCs]). Interrater agreement (ICC=0.94) and intrarater agreement (ICC=0.96) on the MHC were good to excellent. Similarly, inter-rater agreement (kappa 0.66-0.81) and intrarater agreement (kappa 0.64-0.88) on the UERS was either good or excellent. The MHC and the UERS provide standardized, reliable, reproducible, and efficient instruments that can be used by occupational therapists and orthopedic surgeons to evaluate the upper extremities of children with CP.
Reliability of kinematic measures of functional reaching in children with cerebral palsy
Developmental Medicine & Child Neurology, 2010
AIM The determination of rehabilitation effectiveness in children with cerebral palsy (CP) depends on the metric properties of the outcome measure. We evaluated the reliability of kinematic measures of functional upper limb reaching movements in children with CP. METHOD Thirteen children (ten females, three males) with spastic hemiplegic, diplegic, or quadriplegic CP affecting at least one arm (mean age 9y, SD 1.6y; range 6-11y; Manual Ability Classification System [MACS] levels II-IV) were evaluated three times over 5 weeks. The kinematics of the more affected arm reaching to grasp a 2cm 3 block placed at three distances from the body midline were analysed. The reliability (test-retest) of six kinematic variables (endpoint trajectory straightness and smoothness, trunk displacement, elbow extension, shoulder horizontal adduction, and shoulder flexion] was tested and expressed as intraclass correlation coefficients (ICC, model 2,K) and 95% confidence intervals. RESULTS Trajectory smoothness, trunk displacement, elbow extension, and shoulder flexion (far target) had the highest ICCs (0.82-0.95). Other kinematic variables had moderate (0.50£ICC£0.81) or low (0.17-0.38) reliability. Test-retest reliability was task dependent, as reaches required different degrees of trunk displacement and joint excursion. INTERPRETATION Kinematic variables can be used as outcomes in clinical trials to test upper limb intervention effectiveness on motor performance and movement quality. As kinematic variables are task specific, reliability should be interpreted in the context of task requirements.
PloS one, 2017
The clinical application of upper limb (UL) three-dimensional movement analysis (3DMA) in children with unilateral cerebral palsy (uCP) remains challenging, despite its benefits compared to conventional clinical scales. Moreover, knowledge on UL movement pathology and how this relates to clinical parameters remains scarce. Therefore, we investigated UL kinematics across different manual ability classification system (MACS) levels and explored the relation between clinical and kinematic parameters in children with uCP. Fifty children (MACS: I = 15, II = 26, III = 9) underwent an UL evaluation of sensorimotor impairments (grip force, muscle strength, muscle tone, two-point discrimination, stereognosis), bimanual performance (Assisting Hand Assessment, AHA), unimanual capacity (Melbourne Assessment 2, MA2) and UL-3DMA during hand-to-head, hand-to-mouth and reach-to-grasp tasks. Global parameters (Arm Profile Score (APS), duration, (timing of) maximum velocity, trajectory straightness) ...
2022
AimDyskinetic cerebral palsy (DCP) is characterised by involuntary movements, and the movement patterns of children with DCP have not been extensively studied during upper limb tasks. The aim of this study is to evaluate psychometric properties of upper limb kinematics in participants with DCP and typically developing (TD) participants.MethodsTwenty TD participants and 20 participants with DCP performed three functional tasks: reaching forward, reach and grasp vertical and reach sideways during three-dimensional motion analysis. Joint angles at point of task achievement (PTA) and spatio-temporal parameters were evaluated within-and between sessions using intra-class correlation coefficients (ICC) and standard error of measurement (SEM). Independent t-tests/Mann-Whitney U tests were used to compare all parameters between groups.ResultsWithin-session ICC values ranged from 0.55 to 0.99 for joint angles at PTA and spatio-temporal parameters for both groups during all tasks. Within-sess...
2012
Objective: Widely accepted models of disability suggest that actual use of an impaired upper extremity in everyday life frequently deviates from its motor capacity, as measured by laboratory tests. Yet, direct measures of real-world use of an impaired upper extremity are rare in pediatric neurorehabilitation. This paper examines how well the Pediatric Motor Activity Log-Revised (PMAL-R) measures this parameter, when the PMAL-R is administered as a structured interview as originally designed. Design: Parents of 60 children between 2 and 8 years of age with upper-extremity hemiparesis due to cerebral palsy completed the PMAL-R twice. Additionally, the children were videotaped during play structured to elicit spontaneous arm use. More-affected arm use was scored by masked raters; it was thought to reflect everyday activity since no cues were given about which arm to employ. Testing sessions were separated by 3 weeks, during which 29 children received upper-extremity rehabilitation and 31 did not. Results: The PMAL-R had high internal consistency (Cronbach's alpha ϭ .93) and test-retest reliability (r ϭ .89). Convergent validity was supported by a strong correlation between changes in PMAL-R scores and more-affected arm use during play, r(53) ϭ .5, p Ͻ .001. Conclusions: The PMAL-R interview is a reliable and valid measure of upper-extremity pediatric neurorehabilitation outcome.
Occupational Therapy International, 2007
A new computer software program to score video observations, Video Observations Aarts and Aarts (VOAA) was developed to evaluate paediatric occupational therapy interventions. The VOAA is an observation tool that assesses the frequency, duration and quality of arm/hand use in children, in particular those with cerebral palsy. Reliability studies show that the fi rst module, designed to evaluate a forced-use programme, has an excellent content validity index (0.93) and good intra-and inter-observer reliability (Cohen's kappas ranging from 0.62 to 0.85 for the three activities tested). With the built-in statistical package, paediatric occupational therapy departments can conduct therapeutic evaluations with children with impairments in the upper extremities. Further research is recommended to apply the VOAA in clinical studies in paediatric occupational therapy.
Development of a quality-of-movement measure for children with cerebral palsy
Physical therapy, 1991
Development of a suitable measure of quality of movement, or gross motor performance, for children with cerebral palsy is a complex undertaking. A variety of conceptual, methodological, and practical issues inherent in such a project are discussed in this article. We report on the methodology used in the planning and construction of the Gross Motor Performance Measure. The measure has been developed by a multicenter, interdisciplinary group of therapists, methodologists, research staff, and international experts. Five attributes of gross motor performance have been defined, scaled, and operationalized. Results of content validity studies demonstrate that the measure has adequate completeness, clarity, and potential for evaluating change in quality of movement in children who have cerebral palsy. The measure is currently undergoing extensive testing to determine the reliability, validity, and responsiveness of the obtained scores. [Boyce WF, Gowland C, Hardy S, et al. Development of ...