Children with unilateral cerebral palsy (uCP) have upper limb (UL) motor impairments that hinder the realization of activities of daily life, particularly in bimanual situations. The existing three-dimensional motion analysis (3DMA) protocols are limited to unimanual situations or have not been validated. This work aims at proposing a 3DMA child-friendly bimanual protocol and at assessing its feasibility and its reliability on typically developing children (TDC) and uCP children.

Twenty TDC (11.9±3.4 years) and 20 uCP children (12.0±3.2 years) participated by realizing 3 consecutive sessions of the protocol. The protocol consists of 4 complementary bimanual tasks that are integrated into a scenario game of “becoming an airplane pilot” (Fig. 1). It allows the exploration of all degrees of freedom of the UL. Kinematics of the non-dominant/hemiplegic UL was measured using an optoelectronic system (12 cameras). The reliability of the angular waveforms (WAVE), the maximum angles (MAX) and the range of motion values (RoM) has been assessed.

Results showed an excellent reliability for TDC (WAVE: CMC≥0.90; MAX & RoM: ICC≥0.82, SEM≤5.0°) and a very good reliability for uCP children (WAVE: CMC≥0.82; MAX & RoM: ICC≥0.75, SEM≤4.7°), at the exception of a few minor cases. A lower elbow extension, a lower supination and a higher wrist flexion were observed in uCP children compared to TDC.

The very high reliability of the protocol is a very promising result. Its feasibility was excellent for TDC and uCP children, at the exception of one task for uCP children with a high level of deficit (MACS III). Future work consists of adjusting this protocol to all uCP children (MACS I, II, III) and assessing the between-day reliability, before its future deployment as a clinical routine.