Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910 Affoltern am Albis, Switzerland; Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zürich, Switzerland; ETH Zurich, Rämistrasse 101, 8092 Zurich, Switzerland.
Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910 Affoltern am Albis, Switzerland; Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zürich, Switzerland; Doctoral Program Clinical Science, Faculty of Medicine, University of Zurich, University of Zurich Dean's Office Office of the Board of Directors of the Academic Medicine Zurich (UMZH), Pestalozzistrasse 3/5, 8091 Zurich, Switzerland.
Hum Mov Sci. 2021 Jun;77:102790. doi: 10.1016/j.humov.2021.102790. Epub 2021 Mar 30.
Neurophysiological development of selective voluntary motor control (SVMC) is assumed but has not been quantified objectively. We assessed SVMC with (i) clinical assessments, (ii) a combination of these assessments with surface electromyography (sEMG) and, (iii) a playful computer game. The aim of this study was to describe and compare age-related differences in SVMC, quantified with these tools, in neurologically intact children, adolescents, and adults.
We measured upper and lower extremity SVMC with three assessments in 31 children and adolescents. A sample of 33 and 31 adults provided reference values for the upper and lower extremity assessments, respectively. The Selective Control of the Upper Extremity Scale (SCUES) or the Selective Control Assessment of the Lower Extremity (SCALE) were combined with simultaneous sEMG recordings. We quantified SVMC by a similarity index that compared an individual's muscle activation pattern with those of an adult reference group. The SVMC Assessgame required isolated joint movements to steer an avatar and quantified the accuracy of the selective movement and the extent of involuntary movements occurring in not involved joints.
Results from the conventional clinical assessments correlated low to moderately with age (SCUES: r = 0.55, p = 0.013; SCALE: r = 0.44, p = 0.001), while the correlation between the sEMG based similarity index and age was negligible (r ≤ 0.25). The outcomes of the Assessgame correlated highly with age (r ≥ 0.80, p ≤ 0.001). Older children and adolescents performed movements more accurately and with fewer involuntary movements compared to younger participants.
The tools assess and quantify SVMC differently, affecting the way they capture age-related differences in SVMC. Some assessments require reference values from neurologically intact children and adolescents to correctly classify impairments of SVMC in patients with neuromotor disorders.
选择性自愿运动控制（SVMC）的神经生理发育是被假设的，但尚未被客观地量化。我们使用（i）临床评估，（ii）这些评估与表面肌电图（sEMG）的结合，以及（iii）一个有趣的电脑游戏来评估 SVMC。本研究的目的是描述和比较神经功能正常的儿童、青少年和成年人中使用这些工具量化的 SVMC 的年龄相关差异。
我们在 31 名儿童和青少年中使用三种评估方法测量了上肢和下肢的 SVMC。一个由 33 名和 31 名成年人组成的样本分别为上肢和下肢评估提供了参考值。选择性上肢控制量表（SCUES）或选择性下肢控制评估（SCALE）与同时的 sEMG 记录相结合。我们通过比较个体的肌肉激活模式与成人参考组的肌肉激活模式的相似性指数来量化 SVMC。SVMC Assessgame 需要进行孤立的关节运动来操纵一个化身，并量化选择性运动的准确性和不涉及的关节中发生的不随意运动的程度。
传统临床评估的结果与年龄相关的相关性低至中度（SCUES：r=0.55，p=0.013；SCALE：r=0.44，p=0.001），而基于 sEMG 的相似性指数与年龄的相关性可以忽略不计（r≤0.25）。Assessgame 的结果与年龄高度相关（r≥0.80，p≤0.001）。与年轻参与者相比，年龄较大的儿童和青少年的运动更准确，不随意运动较少。
这些工具以不同的方式评估和量化 SVMC，影响了它们捕捉 SVMC 与年龄相关差异的方式。一些评估需要从神经功能正常的儿童和青少年中获得参考值，以便正确分类患有神经运动障碍的患者的 SVMC 损伤。
