Abstract
BackgroundHemiparetic cerebral palsy impacts millions of people worldwide. Assessment of bilateral motor function in real life remains a major challenge. We evaluated quantification of upper extremity movement in hemiparetic children using bilateral actigraphy. We hypothesized that movement asymmetry correlates with standard motor outcome measures.MethodsHemiparetic and control participants wore bilateral wrist Actiwatch2 (Philips) for 48 h with movement counts recorded in 15-s intervals. The primary outcome was a novel statistic of movement asymmetry, the Actigraphic Movement Asymmetry Index (AMAI). Relationships between AMAI and standard motor outcomes (Assisting Hand Assessment, Melbourne Assessment, and Box and Block Test [BB]) were explored with Pearson or Spearman correlation.Results30 stroke (mean 11 years 2 months (3 years 10 months); 13 female, 17 male) and 23 control (mean 11 years 1 month (4 years 5 months); 8 female, 15 male) were enrolled. Stroke participants demonstrated higher asymmetry. Correlations between AMAI and standard tests were moderate and strongest during sleep (BB: r = 0.68, p < 0.01).ConclusionsStandard tests may not reflect the extent of movement asymmetry during daily life in hemiparetic children. Bilateral actigraphy may be a valuable complementary tool for measuring arm movement, potentially enabling improved evaluation of therapies with a focus on child participation.
Highlights
Hemiparetic cerebral palsy impacts millions of people worldwide
We aimed to evaluate the efficacy of bilateral actigraphy to quantify upper extremity movement in children with perinatal stroke and hemiparetic cerebral palsy (HCP), hypothesizing that an actigraphic movement asymmetry index (AMAI) would positively correlate with standard clinical measures of upper extremity function
Demographics and motor outcomes are summarized in Table 1. 30 stroke participants had a mean age of 11 years 2 months (SD 3 years 10 months; range 3 years 10 months–17 years 10 months; 13 female, 17 male). 23 typically-developing participants had a mean age of 11 years 1 month (SD 4 years 5 months; range 1 year 4 months–17 years 11 months; 8 female, 15 male)
Summary
Hemiparetic cerebral palsy impacts millions of people worldwide. Cerebral palsy (CP) accounts for most lifelong neurological disability and affects more than 17 million people worldwide [1,2,3,4]. As a focal injury of defined timing in an otherwise healthy brain, perinatal stroke represents an ideal human model of developmental plasticity [8]. Developmental preclinical and human models have facilitated clinical trials of non-invasive neuromodulation in hemiparetic children [9, 10]. These and other promising trials could benefit from tools capable of measuring bilateral movement during real-life activities
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call