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Assessment of bimanual performance in 3-D movement analysis: validation of a new clinical protocol in children with unilateral cerebral palsy - 11/07/19

Doi : 10.1016/j.rehab.2019.06.008 
Florence Gaillard 1, 2, #, , Marine Cacioppo 1, #, Brice Bouvier 2, Guillaume Bouzille 3, 4, Christopher J. Newman 5, Thibault Pasquet 1, Armel Cretual 2, Hélène Rauscent 1, Isabelle Bonan 1
1 Department of Physical Medicine and Rehabilitation, Rennes University Hospital, 35033 Rennes, France 
2 M2S laboratory (Mouvement Sport Santé), Rennes 2 University – ENS Rennes - UEB, Campus de Ker Lann, 35170 Bruz, France 
3 INSERM U1099, Rennes, F-35000, France 
4 CIC Inserm 1414. Centre de Données Cliniques, Rennes University Hospital, 35033 Rennes, France 
5 Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Nestlé Hospital, CHUV, 1011 Lausanne, Switzerland 

Corresponding author: Rennes University Hospital, Physical Medicine and Rehabilitation, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceRennes University Hospital, Physical Medicine and Rehabilitation, 2 Rue Henri Le GuillouxRennes35033France
Sous presse. Manuscrit accepté. Disponible en ligne depuis le jeudi 11 juillet 2019

Highlights

Bimanual performance is explored with this novel 3-D motion analysis protocol.

This protocol is feasible and reliable in children with unilateral cerebral palsy.

Children with unilateral cerebral palsy show significant kinematic differences as compared with typically developing children.

Relationships are found between kinematic parameters and clinical measures.

Le texte complet de cet article est disponible en PDF.

Abstract

Background. The “Be an Airplane Pilot” (BE-API) protocol is a novel 3-D movement analysis (3DMA) protocol assessing the bimanual performance of children during a game.

Objective. This study aimed to investigate the reliability and validity of this protocol in children with unilateral cerebral palsy (uCP).

Methods. Angular waveforms (WAVE), maximum angles (MAX) and range of motion (ROM) of the trunk, shoulder, elbow and wrist joints were collected in children with uCP and in typically developing children (TDC) during 4 tasks of the BE-API protocol designed to explore specific degrees of freedom (DoF). The inter-trial reliability was assessed with the coefficient of multiple correlation (CMC) for WAVE and the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for MAX and ROM. Clinical performance-based measures, including the Assisting Hand Assessment (AHA) and ABILHAND-Kids scores, were used to explore correlations between clinical measures and kinematic parameters in children with uCP.

Results. For the 20 children with uCP (13 boys; mean age 12.0 [SD 3.2] years) and 20 TDC (11 boys; mean age 11.9 [SD 3.4] years), most kinematic parameters showed high reliability (WAVE: CMC ≥ 0.82; MAX and ROM: ICC ≥ 0.85, SEM ≤ 4.7°). Elbow extension, forearm supination, and wrist adduction were reduced and wrist flexion was increased for children with uCP versus TDC (p<0.01). In children with uCP, MAX and ROM values were moderately correlated with clinical assessments (AHA score: r = 0.48-0.65; ABILHAND-Kids score: r = 0.48-0.49).

Conclusions. The BE-API protocol is a 3DMA bimanual performance-based assessment that is highly reliable in children with uCP. Children with uCP and TDC significantly differed in some clinically relevant kinematic parameters. The BE-API is a promising playful tool, helpful for better understanding upper-limb motor movement abnormalities in bimanual conditions and for tailoring treatments to individual deficits.

Le texte complet de cet article est disponible en PDF.

Keywords : Unilateral cerebral palsy, 3-D movement analysis, upper limb, bimanual task, bimanual performance



© 2019  Publié par Elsevier Masson SAS.
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