A tablet computer “app” for neuromusculoskeletal physical examination in children with cerebral palsy

Abstract

Introduction: Physical examination of neuromusculoskeletal and movement-related functions is commonly performed in children with cerebral palsy (CP). Next to instrumented gait analysis, neuromusculoskeletal physical examination (NMS-PE) is an essential element in clinical decision-making, especially when orthopaedic or neurosurgery is indicated. Taking a complete NMSPE is rather extensive, so the examination and its registration can take quite some time. Accordingly, not all NMS-PE items are always performed, leading to incompleteness of data. Also paper based forms are subjected to data entry mistakes, and might even get lost. Altogether, thismay result in suboptimaldecision-making. The quality of NMSPE will be improved by technology that supports taking a PE. The aim of this project was to develop an innovative, easy touse tool (an “app”) for data entry anddata storageofNMS-PE findings in children with CP. Patients/materials and methods: The content of the NMS-PE tool is based on a recently published guideline book [1]. Requirements and a functional design of the app were drafted in close cooperationwithhealth-careprofessionals. Basedon these requirements, a user interfacewas developed, aswell as a database to store the entered data. A prototype of the NMS-PE app was tested in a pilot study. During the pilot study, NMS-PEs were performed in children with CP whom were seen for a first appointment at the outpatient clinic of a university hospital. Examinations were performed with the old method (manual data entry on paper sheets) and with the new method (digital data entry) on a second cohort. Factors of success and failure were documented during the pilot. Furthermore, efficiency (time to perform the examination), completeness of data registration (% completed items) and satisfaction were evaluated. RESULTS