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一种新的针对单侧脑瘫儿童的三维双手协议的提案:在正常发育儿童中的可靠性。

Proposal of a new 3D bimanual protocol for children with unilateral cerebral palsy: Reliability in typically developing children.

机构信息

Univ Rennes, M2S - EA 7470, F-35000 Rennes, France.

Univ Rennes, M2S - EA 7470, F-35000 Rennes, France; Department of Physical Medicine and Rehabilitation, CHU Rennes, 35033 Rennes, France.

出版信息

J Electromyogr Kinesiol. 2019 Dec;49:102347. doi: 10.1016/j.jelekin.2019.08.001. Epub 2019 Aug 16.

DOI:10.1016/j.jelekin.2019.08.001
PMID:31479929
Abstract

INTRODUCTION

Quantitative evaluation of upper limb (UL) kinematics in children with unilateral cerebral palsy (uCP) remains challenging for researchers and clinicians, especially during bimanual situations. This study proposed a new 3D bimanual protocol dedicated to children with uCP, called "Be an Airplane Pilot" (BE-API protocol) and assessed its reliability for typically developing children (TDC).

METHODS

this protocol is composed of four bimanual tasks that allow the exploration of all degrees of freedom of the hemiplegic/non-dominant UL. Twenty TDC (mean age 11.9 ± 3.4) carried out three protocol sessions. Reliability was investigated through three kinematic parameters: angular waveforms (WAVE) using the coefficient of multiple correlation (CMC), range of motion (RoM) and maximum angles (MAX) both using the intra-class correlation coefficient (ICC) and the standard error of measurement (SEM).

RESULTS

A very good reliability was observed for the three kinematic parameters in most cases (WAVE: CMC ≥0.90, RoM & MAX: ICC ≥0.81, SEM ≤5.0°).

DISCUSSION

the very good reliability can be partly explained by the high level of rigor of the protocol. Such promising results open the door to validation tests on children with uCP. The BE-API protocol could pretend to support clinical decisions by objectively assessing the efficiency of therapeutics, e.g. injection of botulinic toxin.

摘要

简介

定量评估单侧脑瘫(uCP)儿童的上肢(UL)运动学对于研究人员和临床医生来说仍然具有挑战性,尤其是在双手情况中。本研究提出了一种新的 3D 双手协议,专门针对 uCP 儿童,称为“成为飞机驾驶员”(BE-API 协议),并评估了其对典型发育儿童(TDC)的可靠性。

方法

该协议由四个双手任务组成,允许探索偏瘫/非优势 UL 的所有自由度。二十名 TDC(平均年龄 11.9±3.4)进行了三次协议会议。通过三个运动学参数来研究可靠性:使用多重相关系数(CMC)的角度波(WAVE),使用组内相关系数(ICC)和测量标准误差(SEM)的运动范围(RoM)和最大角度(MAX)。

结果

在大多数情况下,三个运动学参数的可靠性非常好(WAVE:CMC≥0.90,RoM 和 MAX:ICC≥0.81,SEM≤5.0°)。

讨论

如此高的可靠性可以部分解释为协议的高标准。这些有希望的结果为在 uCP 儿童中进行验证测试开辟了道路。BE-API 协议可以通过客观评估治疗效果(例如注射肉毒毒素)来支持临床决策。

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