Abstract
Background and aimUnderstanding the maturation of upper limb (UL) movement characteristics in typically developing (TD) children is key to explore UL deficits in those with neurodevelopmental disorders. Three-dimensional motion analysis (3DMA) offers a reliable tool to comprehensively evaluate UL motion. However, studies thus far mainly focused on specific pre-defined parameters extracted from kinematic waveforms. Here, we investigated age-related differences in UL movement characteristics over the entire movement cycle in TD children.Participants and methodsWe assessed the non-dominant UL of 60 TD children (mean age 10y3m±3y1m) using 3DMA during eight tasks: reaching (forwards (RF), upwards (RU), sideways (RS)), reach-to-grasp (sphere (RGS), vertical cylinder (RGV)) and activities-of-daily-living mimicking tasks (hand-to-head (HTH), hand-to-mouth (HTM), hand-to-shoulder (HTS)). We investigated differences between four age-groups (5-7y, 8-10y, 11-12y, 13-15y) in: (1) spatiotemporal parameters (movement duration, peak velocity, time-to-peak velocity and trajectory straightness), and (2) 12 UL joint angles, using Statistical Parametric Mapping (SPM).ResultsWe found that the 5-7y children moved with lower peak velocity and less straight trajectories compared to the 11-12y group (peak velocity: RS, HTS, p<0.01; trajectory: RU, RS, RGV, HTS, p<0.01) and the 13-15y group (peak velocity: RF, RS, RGS, RGV, HTH, HTS, p<0.01; trajectory, all tasks, p<0.01). The 5-7y children showed increased scapular protraction compared to older children (8-10y and 11-12y, HTS), as well as increased scapular medial rotation compared to the 13-15y group (RGS). During RU, the 5-7y children moved more towards the frontal plane (shoulder), unlike the 13-15y group. Lastly, the 5-7y group used less elbow flexion than older children (11-12y and 13-15y) during HTH and HTS.Discussion and conclusionIn conclusion, our results point toward a maturation in UL movement characteristics up to age 11-12y, when UL motion seemed to reach a plateau. The reference values provided in this study will help to further optimize the interpretation of UL deficits in children with neurodevelopmental disorders.
Highlights
Upper limb (UL) motion is essential for the motor, social and cognitive development of children as it allows interaction between the individual and his/her environment
The development of UL motion may be compromised by the presence of a neurodevelopmental disorder, such as cerebral palsy, Duchenne’s muscular dystrophy or brachial plexus palsy, which may negatively influence the performance of activities of daily living (ADL) and potentially affect the child’s participation and quality of life [1,2]
We found that typical UL motion becomes faster and straighter with age, and seems to reach a plateau around the age of 11-12y, and this was true for all UL tasks
Summary
Upper limb (UL) motion is essential for the motor, social and cognitive development of children as it allows interaction between the individual and his/her environment. In typically developing (TD) children, the development of reaching and grasping skills has been investigated using three-dimensional motion analysis (3DMA). Previous studies have shown a considerable improvement of smoothness and trajectory straightness throughout the first years of life [3,4,5,6] and reported a mature coordination between arm and trunk movements around the age of 4 years [3]. The vast amount of 3DMA literature on the development of reaching tasks is contrasted by only a few studies that reported age-differences in UL kinematics during ADL-mimicking tasks [9,10]. Understanding the maturation of upper limb (UL) movement characteristics in typically developing (TD) children is key to explore UL deficits in those with neurodevelopmental disorders. We investigated age-related differences in UL movement characteristics over the entire movement cycle in TD children.
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