Bimanual Movements in Children with Cerebral Palsy: a Systematic Review of Instrumented Assessments

Overview

Journal J Neuroeng Rehabil

Publisher Biomed Central

Specialties Biomedical Engineering
Neurology
Rehabilitation Medicine

Date 2023 Feb 28

PMID 36849971

Authors

Marine Cacioppo

Anthea Loos

Mathieu Lempereur

Sylvain Brochard

Affiliations

Soon will be listed here.

Abstract

Background: Assessment of bimanual movements, which are frequently impaired in children with cerebral palsy, is highly challenging in clinical practice. Instrumented measures have been developed to evaluate and help to understand impaired upper limb movement during bimanual tasks in these children. The aim of this review was to report instrumented measurement tools (3D motion analysis, sensors, etc.) used for bimanual task movement analysis, and the metrological properties of the measures in children with cerebral palsy.

Methods: A systematic review was conducted (Prospero CRD42022308517). PubMed, Web of Science, Cochrane and Scopus databases were searched with relevant keywords and inclusion/exclusion criteria. Article quality and biomechanical methods were evaluated with a customized scale and metrological properties with the COSMIN checklist.

Results: In total, 452 children, mostly with unilateral cerebral palsy, mean age 10.9 (SD 3.2) years, underwent quantitative bimanual assessments in the 31 included studies (mean quality score 22/32 points [SD 4.7]). The tools used were 3D motion analysis (n = 26), accelerometers (n = 2), and other instruments (cube, digitizer, etc.) (n = 3). Children performed 1-5 bimanual tasks in laboratory settings, mostly activities of daily living or game scenarios. Analyses focused mostly on spatiotemporal variables, 6 of which were specifically developed for bilateral measures (task completion time, goal synchronization, movement overlap time, interlimb coupling, continuous relative phase and asynchrony). These instrumented measurements had moderate to good discriminant and convergent validity, but reliability and responsiveness assessments were lacking.

Conclusions: A large number of quantitative bimanual assessments involving different tools, bimanual tasks and specific variables developed to evaluate bimanual function were found. Development of other relevant variables and validation of these tools are needed to further determine their usefulness, both as research outcomes and to guide therapies in clinical practice. Future research, involving younger children and real-life assessments, will improve our understanding of bimanual function in children with cerebral palsy.

Citing Articles

Feasibility of At-Home Hand Arm Bimanual Intensive Training in Virtual Reality: Case Study.

Gehringer J, Woodruff Jameson A, Boyer H, Konieczny J, Thomas R, Pierce Iii J JMIR Form Res. 2024; 8:e57588.

PMID: 39241226 PMC: 11415726. DOI: 10.2196/57588.

A systematic review of instrumented assessments for upper limb function in cerebral palsy: current limitations and future directions.

Rozaire J, Paquin C, Henry L, Agopyan H, Bard-Pondarre R, Naaim A J Neuroeng Rehabil. 2024; 21(1):56.

PMID: 38622731 PMC: 11020208. DOI: 10.1186/s12984-024-01353-6.

In-depth quantification of bimanual coordination using the Kinarm exoskeleton robot in children with unilateral cerebral palsy.

Decraene L, Orban de Xivry J, Kleeren L, Crotti M, Verheyden G, Ortibus E J Neuroeng Rehabil. 2023; 20(1):154.

PMID: 37951867 PMC: 10640737. DOI: 10.1186/s12984-023-01278-6.

Motor control differs for increasing and decreasing force production during ankle Isometric exercises in children.

Xiong Q, Mo J, Yi C, Jiang S, Liu Y BMC Sports Sci Med Rehabil. 2023; 15(1):120.

PMID: 37740224 PMC: 10517481. DOI: 10.1186/s13102-023-00727-y.

Detecting Movement Changes in Children with Hemiparesis after Upper Limb Therapies: A Responsiveness Analysis of a 3D Bimanual Protocol.

Cacioppo M, Lempereur M, Houx L, Bouvier S, Bailly R, Brochard S Sensors (Basel). 2023; 23(9).

PMID: 37177439 PMC: 10181373. DOI: 10.3390/s23094235.

References

VAN THIEL E, Steenbergen B . Shoulder and hand displacements during hitting, reaching, and grasping movements in hemiparetic cerebral palsy. Motor Control. 2001; 5(2):166-82. DOI: 10.1123/mcj.5.2.166. View

Klingels K, Demeyere I, Jaspers E, De Cock P, Molenaers G, Boyd R . Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy. Eur J Paediatr Neurol. 2012; 16(5):475-84. DOI: 10.1016/j.ejpn.2011.12.008. View

Smorenburg A, Ledebt A, Deconinck F, Savelsbergh G . Practicing a matching movement with a mirror in individuals with spastic hemiplegia. Res Dev Disabil. 2013; 34(9):2507-13. DOI: 10.1016/j.ridd.2013.05.001. View

Hung Y, Zeng W . Accuracy Constraints Improve Symmetric Bimanual Coordination for Children with and without Unilateral Cerebral Palsy. Dev Neurorehabil. 2019; 23(3):176-184. DOI: 10.1080/17518423.2019.1616845. View

Utley A, Sugden D . Interlimb coupling in children with hemiplegic cerebral palsy during reaching and grasping at speed. Dev Med Child Neurol. 1998; 40(6):396-404. View

Howcroft J, Klejman S, Fehlings D, Wright V, Zabjek K, Andrysek J . Active video game play in children with cerebral palsy: potential for physical activity promotion and rehabilitation therapies. Arch Phys Med Rehabil. 2012; 93(8):1448-56. DOI: 10.1016/j.apmr.2012.02.033. View

Terwee C, Mokkink L, Knol D, Ostelo R, Bouter L, de Vet H . Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res. 2011; 21(4):651-7. PMC: 3323819. DOI: 10.1007/s11136-011-9960-1. View

Rudisch J, Butler J, Izadi H, Zielinski I, Aarts P, Birtles D . Kinematic parameters of hand movement during a disparate bimanual movement task in children with unilateral Cerebral Palsy. Hum Mov Sci. 2016; 46:239-50. DOI: 10.1016/j.humov.2016.01.010. View

Hung Y, Casertano L, Hillman A, Gordon A . The effect of intensive bimanual training on coordination of the hands in children with congenital hemiplegia. Res Dev Disabil. 2011; 32(6):2724-31. DOI: 10.1016/j.ridd.2011.05.038. View

10.

Braendvik S, Elvrum A, Vereijken B, Roeleveld K . Relationship between neuromuscular body functions and upper extremity activity in children with cerebral palsy. Dev Med Child Neurol. 2009; 52(2):e29-34. DOI: 10.1111/j.1469-8749.2009.03490.x. View

11.

Demont A, Gedda M, Lager C, de Lattre C, Gary Y, Keroulle E . Evidence-Based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy. Neurology. 2022; 99(7):283-297. DOI: 10.1212/WNL.0000000000200936. View

12.

Pons C, Remy-Neris O, Medee B, Brochard S . Validity and reliability of radiological methods to assess proximal hip geometry in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2013; 55(12):1089-102. DOI: 10.1111/dmcn.12169. View

13.

Hung Y, Brandao M, Gordon A . Structured skill practice during intensive bimanual training leads to better trunk and arm control than unstructured practice in children with unilateral spastic cerebral palsy. Res Dev Disabil. 2016; 60:65-76. DOI: 10.1016/j.ridd.2016.11.012. View

14.

Smorenburg A, Ledebt A, Deconinck F, Savelsbergh G . Matching accuracy in hemiparetic cerebral palsy during unimanual and bimanual movements with (mirror) visual feedback. Res Dev Disabil. 2012; 33(6):2088-98. DOI: 10.1016/j.ridd.2012.06.004. View

15.

Gaillard F, Cacioppo M, Bouvier B, Bouzille G, Newman C, Pasquet T . 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. 2019; 63(5):408-415. DOI: 10.1016/j.rehab.2019.06.008. View

16.

Jaspers E, Desloovere K, Bruyninckx H, Molenaers G, Klingels K, Feys H . Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy. Gait Posture. 2009; 30(4):395-404. DOI: 10.1016/j.gaitpost.2009.07.110. View

17.

Klotz M, van Drongelen S, Rettig O, Wenger P, Gantz S, Dreher T . Motion analysis of the upper extremity in children with unilateral cerebral palsy--an assessment of six daily tasks. Res Dev Disabil. 2014; 35(11):2950-7. DOI: 10.1016/j.ridd.2014.07.021. View

18.

Utley A, Steenbergen B, Sugden D . The influence of object size on discrete bimanual co-ordination in children with hemiplegic cerebral palsy. Disabil Rehabil. 2004; 26(10):603-13. DOI: 10.1080/09638280410001696674. View

19.

Downs S, Black N . The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998; 52(6):377-84. PMC: 1756728. DOI: 10.1136/jech.52.6.377. View

20.

Pons C, Borotikar B, Garetier M, Burdin V, Ben Salem D, Lempereur M . Quantifying skeletal muscle volume and shape in humans using MRI: A systematic review of validity and reliability. PLoS One. 2018; 13(11):e0207847. PMC: 6264864. DOI: 10.1371/journal.pone.0207847. View