Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, Daejeon-Chungcheong Regional Rehabilitation Center, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Gait Posture. 2022 Jan;91:326-331. doi: 10.1016/j.gaitpost.2020.11.007. Epub 2020 Nov 12.
There are various tools that measure upper limb function in children with cerebral palsy(CP) clinically, but these measurement methods are examiner-dependent and scale values are not proportional to the upper limb function which makes it difficult to quantify the function.
The purpose of this study was to investigate whether the new parameters derived from 3D motion analysis reflect the upper limb function which measured by Melbourne Assessment 2 (MA2) in children with cerebral palsy (CP) compared to the clinical measurements.
Forty children with CP (24 boys, 16 girls; mean [SD] age, 6 years 11 months [3 years 5 months]) were recruited. Motion capture was conducted during phases T1-T4 of Reach and Grasp Cycles. New parameters (movement time, number of movement units, index of curvature) were derived from wrist marker data. Range of motion (ROM), accuracy, dexterity, and fluency of unilateral upper limb function were assessed using MA2. Spearman rank coefficients were determined to evaluate correlations between MA2 and the new parameters.
Index of curvature correlated negatively with MA2 accuracy scores during T1 (r -0.347, p < 0.05), T2 (r -0.471, p < 0.01), and T3 (r -0.660, p < 0.01). Number of movement units correlated negatively with MA2 ROM, accuracy, and fluency scores during T1 (ROM r -0.334; accuracy r -0.331; fluency r -0.375; p < 0.05) and T3 (ROM r -0.499; accuracy r -0.531; fluency r -0.515; p < 0.01). Index of curvature and number of movement units are objective, simple parameters showing fair to good correlation with MA2 accuracy and fluency of upper limb function.
临床上有多种工具可测量脑瘫儿童的上肢功能，但这些测量方法依赖于检查者，且量表值与上肢功能不成比例，难以量化功能。
本研究旨在探讨 3D 运动分析得出的新参数是否能反映脑瘫儿童上肢功能，与临床测量相比，这些参数与墨尔本评估 2 （MA2）测量的上肢功能是否相关。
共招募 40 名脑瘫儿童（男 24 名，女 16 名；平均[标准差]年龄为 6 岁 11 个月[3 岁 5 个月]）。在伸手和抓握周期的 T1-T4 阶段进行运动捕捉。从腕部标记数据中得出新参数（运动时间、运动单元数量、曲率指数）。使用 MA2 评估单侧上肢功能的运动范围（ROM）、准确性、灵巧性和流畅性。采用 Spearman 秩相关系数评估 MA2 与新参数之间的相关性。
在 T1（r=-0.347，p<0.05）、T2（r=-0.471，p<0.01）和 T3（r=-0.660，p<0.01）期间，曲率指数与 MA2 准确性评分呈负相关。运动单元数量与 MA2 ROM、准确性和流畅性评分在 T1（ROM r=-0.334；准确性 r=-0.331；流畅性 r=-0.375；p<0.05）和 T3（ROM r=-0.499；准确性 r=-0.531；流畅性 r=-0.515；p<0.01）期间呈负相关。曲率指数和运动单元数量是客观、简单的参数，与 MA2 准确性和上肢功能的流畅性具有良好到中度的相关性。
