Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy.

Cristina Carmona-Pérez,Lourdes García-Luque,Sandra Alcaraz-Clariana,Juan L Garrido-Castro,Alberto Pérez-Ruiz,Francisco Torres Vidal,Francisco Alburquerque-Sendín,Daiana Priscila Rodrigues-De-Souza

doi:10.3390/diagnostics10090661

Cristina Carmona-Pérez, Lourdes García-Luque + Show 6 more

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https://doi.org/10.3390/diagnostics10090661

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Abstract

Objective: The aim of this study was to design and propose a new test based on inertial measurement unit (IMU) technology, for measuring cervical posture and motor control in children with cerebral palsy (CP) and to evaluate its validity and reliability. Methods: Twenty-four individuals with CP (4–14 years) and 24 gender- and age-matched controls were evaluated with a new test based on IMU technology to identify and measure any movement in the three spatial planes while the individual is seated watching a two-minute video. An ellipse was obtained encompassing 95% of the flexion/extension and rotation movements in the sagittal and transversal planes. The protocol was repeated on two occasions separated by 3 to 5 days. Construct and concurrent validity were assessed by determining the discriminant capacity of the new test and by identifying associations between functional measures and the new test outcomes. Relative reliability was determined using the intraclass correlation coefficient (ICC) for test–retest data. Absolute reliability was obtained by the standard error of measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90). Results: The discriminant capacity of the area and both dimensions of the new test was high (Area Under the Curve ≈ 0.8), and consistent multiple regression models were identified to explain functional measures with new test results and sociodemographic data. A consistent trend of ICCs higher than 0.8 was identified for CP individuals. Finally, the SEM can be considered low in both groups, although the high variability among individuals determined some high MDC90 values, mainly in the CP group. Conclusions: The new test, based on IMU data, is valid and reliable for evaluating posture and motor control in children with CP.

Highlights

Cerebral palsy (CP) is a group of permanent disorders, attributed to a non-progressive damage during the fetal period or during the first years of life [1], that affects the normal development of Diagnostics 2020, 10, 661; doi:10.3390/diagnostics10090661 www.mdpi.com/journal/diagnosticsDiagnostics 2020, 10, 661 movement and posture, causing disability and activity limitations [2]
The negative consequences of the alterations on posture and motor control of the craniocervical region in cerebral palsy (CP) include, among others, an exacerbation of any feeding or swallowing disorder by the appearance of abnormal muscle tone and movement patterns [10]; a deterioration of the visual and vestibular senses, since the head is responsible for the directional orientation and its movements influence and are influenced by the information that both sensory faculties provide [11,12]; and, associated to the alterations of the cranial senses, an increased risk of falls, because the maintenance of head stability has been identified as an important part of locomotor activity [13]
For the GMFM-88 total score, the model achieved a 63.8% explanation of variance including the flexion-extension angle root mean square error (RMSE) and two sociodemographic variables

Summary

Introduction

Cerebral palsy (CP) is a group of permanent disorders, attributed to a non-progressive damage during the fetal period or during the first years of life [1], that affects the normal development of Diagnostics 2020, 10, 661; doi:10.3390/diagnostics10090661 www.mdpi.com/journal/diagnosticsDiagnostics 2020, 10, 661 movement and posture, causing disability and activity limitations [2]. Cerebral palsy is associated with sensory deficits, cognitive, communication, and behavioral disorders, together with epilepsy and motor function disorders, represent the core symptoms [2], with spastic paresis being one of the most common forms of presentation [6,7]. This impairs the posture [8] and motor control [9], including the craniocervical region. Other specific approaches are necessary in clinical settings and in research [11,18] based on the analysis of movement and posture [19]

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