Assessment of bimanual performance in 3-D movement analysis: Validation of a new clinical protocol in children with unilateral cerebral palsy

Florence Gaillard; Marine Cacioppo; Brice Bouvier; Guillaume Bouzille; Christopher J Newman; Thibault Pasquet; Armel Cretual; Hélène Rauscent; Isabelle Bonan

doi:10.1016/j.rehab.2019.06.008

Assessment of bimanual performance in 3-D movement analysis: Validation of a new clinical protocol in children with unilateral cerebral palsy

Ann Phys Rehabil Med. 2020 Oct;63(5):408-415. doi: 10.1016/j.rehab.2019.06.008. Epub 2019 Jul 10.

Authors

Florence Gaillard¹, Marine Cacioppo², Brice Bouvier³, Guillaume Bouzille⁴, Christopher J Newman⁵, Thibault Pasquet², Armel Cretual³, Hélène Rauscent², Isabelle Bonan²

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Rennes University Hospital, 35033 Rennes, France; M2S laboratory (Mouvement Sport Santé), Rennes 2 University-ENS Rennes - UEB, Campus de Ker Lann, 35170 Bruz, France. Electronic address: florence-gaillard@hotmail.fr.
² Department of Physical Medicine and Rehabilitation, Rennes University Hospital, 35033 Rennes, France.
³ M2S laboratory (Mouvement Sport Santé), Rennes 2 University-ENS Rennes - UEB, Campus de Ker Lann, 35170 Bruz, France.
⁴ INSERM U1099, 35000 Rennes, France; CIC Inserm 1414. Centre de Données Cliniques, Rennes University Hospital, 35033 Rennes, France.
⁵ Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Nestlé Hospital, CHUV, 1011 Lausanne, Switzerland.

PMID: 31301386
DOI: 10.1016/j.rehab.2019.06.008

Abstract

Background: The "Be an Airplane Pilot" (BE-API) protocol is a novel 3-D movement analysis (3DMA) protocol assessing the bimanual performance of children during a game.

Objective: This study aimed to investigate the reliability and validity of this protocol in children with unilateral cerebral palsy (uCP).

Methods: Angular waveforms (WAVE), maximum angles (MAX) and range of motion (ROM) of the trunk, shoulder, elbow and wrist joints were collected in children with uCP and in typically developing children (TDC) during 4 tasks of the BE-API protocol designed to explore specific degrees of freedom (DoF). The inter-trial reliability for children with uCP was assessed with the coefficient of multiple correlation (CMC) for WAVE and the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for MAX and ROM. Clinical performance-based measures, including the Assisting Hand Assessment (AHA) and ABILHAND-Kids scores, were used to explore correlations between clinical measures and kinematic parameters in children with uCP.

Results: 20 children with uCP (13 boys; mean age 12.0 [SD 3.2] years) and 20 TDC (11 boys; mean age 11.9 [SD 3.4] years) were included. In children with uCP, most kinematic parameters showed high reliability (WAVE: CMC≥0.82; MAX and ROM: ICC≥0.85, SEM≤4.7°). Elbow extension, forearm supination, and wrist adduction were reduced and wrist flexion was increased for children with uCP versus TDC (P<0.01). In children with uCP, MAX and ROM values were moderately correlated with clinical assessments (AHA score: r=0.48-0.65; ABILHAND-Kids score: r=0.48-0.49).

Conclusions: The BE-API protocol is a 3DMA-bimanual performance-based assessment that is highly reliable in children with uCP. Children with uCP and TDC significantly differed in some clinically relevant kinematic parameters. The BE-API is a promising playful tool, helpful for better understanding upper-limb motor movement abnormalities in bimanual conditions and for tailoring treatments to individual deficits.

Keywords: 3-D movement analysis; Bimanual performance; Bimanual task; Unilateral cerebral palsy; Upper limb.

MeSH terms

Adolescent
Cerebral Palsy*
Child
Clinical Protocols
Female
Hand
Humans
Male
Movement
Reproducibility of Results
Upper Extremity