Department of Physical Medicine and Rehabilitation, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France.
Laboratoire de Traitement de L'information Médicale (LaTIM), Inserm U1101, Université de Bretagne-Occidentale, 29200, Brest, France.
J Neuroeng Rehabil. 2023 Feb 27;20(1):26. doi: 10.1186/s12984-023-01150-7.
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.
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.
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.
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.
评估脑瘫儿童经常受损的双手运动在临床实践中极具挑战性。已经开发出仪器测量来评估和帮助理解这些儿童在双手任务中受损的上肢运动。本综述的目的是报告用于双手任务运动分析的仪器测量工具（三维运动分析、传感器等），以及脑瘫儿童测量的计量学特性。
进行了系统综述（Prospéro CRD42022308517）。使用相关关键词和纳入/排除标准在 PubMed、Web of Science、Cochrane 和 Scopus 数据库中进行搜索。使用定制量表评估文章质量和生物力学方法，使用 COSMIN 清单评估计量学特性。
共有 452 名儿童（主要为单侧脑瘫，平均年龄 10.9 [3.2] 岁）参与了 31 项纳入研究的定量双手评估（平均质量评分 22/32 分 [4.7]）。使用的工具包括三维运动分析（n=26）、加速度计（n=2）和其他仪器（立方块、数字化仪等）（n=3）。儿童在实验室环境中进行 1-5 项双手任务，主要是日常生活活动或游戏场景。分析主要集中在时空变量上，其中 6 个变量专门用于双侧测量（任务完成时间、目标同步、运动重叠时间、肢体间耦合、连续相对相位和异步）。这些仪器测量具有中等至良好的判别和收敛效度，但缺乏可靠性和反应性评估。
发现了大量涉及不同工具、双手任务和特定变量的定量双手评估，这些评估旨在评估双手功能。需要开发其他相关变量并验证这些工具，以进一步确定其在研究结果和指导临床实践治疗中的有用性。涉及年幼儿童和现实生活评估的未来研究将增进我们对脑瘫儿童双手功能的理解。
