Reliability of kinematic measures of functional reaching in children with cerebral palsy

Abstract

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.

The reliability of upper limb kinematics in children with hemiplegic cerebral palsy

“…Schneiberg et al [12] previously reported between session reliability during a reach-to-grasp task. They found somewhat higher measurement errors for elbow and shoulder flexion (SEM b 5.3-6.38) compared to our results for RGS (SEM b 2.6-3.28).…”

“…Clinical implementation of the measurement procedure additionally requires the establishment of its reliability in patient groups. Schneiberg et al [12] previously reported between session reliability of endpoint spatial and kinematic parameters during reach-to-grasp objects at different distances. They reported overall moderate to excellent reliability for elbow and shoulder flexion, with measurement errors ranging from 58 to 108.…”

Measuring movement fluency during the sit-to-walk task

“…Visual observation of movement fluency is used by therapists to guide the planning and evaluation of interventions aimed at restoring movement [27]. Improving movement fluency is perceived by therapists to be associated with improvements in function [6], and has been shown to relate to energy cost [33].…”

Reproducibility of kinematics indexes of upper arm reaching movement in robot assisted therapy

“…Despite fundamental to this scope is the knowledge of the uncertainty about kinematics indexes measurements, very few papers [4] have actually addressed the problem of reproducibility of these indexes; perhaps because kinematics variables are task specific so that reliability should be interpreted in the context of task requirements, depending on type, amplitude and velocity of the motor task and because has not yet reached a common consensus on kinematics indexes and algorithms to use.…”