Wearable wrist activity monitor as an indicator of functional hand use in children with cerebral palsy

Abstract

AHA Assisting Hand Assessment FreqE Extension frequency RangeFE Range of wrist flexion and extension AIM New tools that capture hand function in everyday activities and contexts are needed for assessing children with hemiplegic cerebral palsy. This study evaluates a wearable wrist monitor and tests the hypothesis that wrist extension frequency (FreqE) is an appropriate indicator of functional hand use. METHOD Fifteen children (four females, 11 males; age range 6-12y; mean age 10y [SD 2y]) with hemiplegia (seven at level I and eight at level II on the Manual Ability Classification System) participated in the Assisting Hand Assessment (AHA) while wearing the wrist monitor. FreqEs were captured via the wrist monitor and validated using video analysis. Correlations between FreqE and AHA scores were calculated and a multivariate linear regression was conducted to explore other measures of wrist activity. RESULTS Wrist extensions observed in video analyses were reliably detected by the wrist monitor (intraclass correlation coefficient, r=0.88; p<0.001) and were strongly correlated with the AHA scores (r=0.93; p<0.001). AHA scores were significantly correlated with FreqE (r=0.80; p=0.001) and the range of wrist extensions ⁄ flexions (r=0.70; p=0.008). The multivariate linear regression combining the FreqE and range of wrist extensions ⁄ flexions yielded a strong correlation with AHA scores (r=0.84; p=0.0043).

Wearable wrist activity monitor as an indicator of functional hand use in children with cerebral palsy

“…The sensor developed by Howcroft et al 1 aims to quantify typical hand function in children with cerebral palsy in everyday contexts such as home, school, and during play. Considering the availability of valid and reliable clinician-administered instruments that evaluate hand function (e.g.…”

“…Howcroft et al 1 also demonstrate the complexities which are associated with applying new technologies to patient measurement. Systems designed for use on adults are often not suitable to be applied to paediatric populations because of differences in the size of limbs and frequency of movements.…”

“…Along these lines, participation was defined as involvement in life situations and daily activities which are necessary for development, life experiences, and well-being. 1 An additional important contribution of the ICF model lies in its introducing the environment as the context in…”

“…The article by Howcroft et al 1 . poses interesting questions regarding clinical measurement: what type of variables are measured during patient management, how are they measured, and the meaning of the information gained in the context of patient management.…”

“…poses interesting questions regarding clinical measurement: what type of variables are measured during patient management, how are they measured, and the meaning of the information gained in the context of patient management. The sensor developed by Howcroft et al 1 . aims to quantify typical hand function in children with cerebral palsy in everyday contexts such as home, school, and during play.…”