Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.
Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
BMC Pediatr. 2024 Apr 25;24(1):273. doi: 10.1186/s12887-024-04724-z.
Accurate assessment of physical activity and motor function in children with cerebral palsy is crucial for determining the effectiveness of interventions. This study aimed to investigate the correlation between real-world activity monitoring outcomes and in-laboratory standardized hand function assessments in children with unilateral cerebral palsy.
Actigraphy data were collected over 3 days from children aged 4-12 years with unilateral cerebral palsy before in-laboratory assessments. To tackle the high dimensionality and collinearity of actigraphy variables, we first applied hierarchical clustering using the Pearson correlation coefficient as the distance metric and then performed a principal component analysis (PCA) to reduce the dimensionality of our data.
Both hierarchical clustering and PCAs revealed a consistent pattern in which magnitude ratio variables (ln[affected side magnitude/less-affected side magnitude]) were more strongly associated with standardized assessments of hand function than with activity time and distance domain variables. Hierarchical clustering analysis identified two distinct clusters of actigraphy variables, with the second cluster primarily consisting of magnitude ratio variables that exhibited the strongest correlation with Melbourne Assessment 2, Pediatric Motor Activity Log, Assisting Hand Assessment, and Manual Ability Classification System level. Principal component 2, primarily representing the magnitude ratio domain, was positively associated with a meaningful portion of subcategories of standardized measures, whereas principal component 1, representing the activity time and distance component, showed limited associations.
The magnitude ratio of actigraphy can provide additional objective information that complements in-laboratory hand function assessment outcomes in future studies of children with unilateral cerebral palsy. TRIAL REGISTRATION IN CLINICALTRIALS.GOV: NCT04904796 (registered prospectively; date of registration: 23/05/2021).
准确评估脑瘫儿童的身体活动和运动功能对于确定干预措施的有效性至关重要。本研究旨在探讨脑瘫儿童真实世界活动监测结果与实验室标准化手功能评估之间的相关性。
在实验室评估前，对 4-12 岁单侧脑瘫儿童进行为期 3 天的活动监测数据采集。为了解决活动监测变量的高维度和共线性问题，我们首先使用皮尔逊相关系数作为距离度量进行层次聚类分析，然后进行主成分分析（PCA）以降低数据的维度。
层次聚类分析和 PCA 均揭示出一致的模式，即幅度比变量（ln[患侧幅度/健侧幅度]）与手功能的标准化评估比活动时间和距离域变量更密切相关。层次聚类分析确定了活动监测变量的两个不同聚类，第二个聚类主要由幅度比变量组成，与墨尔本评估 2、儿科运动活动日志、辅助手评估和手动能力分类系统水平具有最强相关性。主成分 2 主要代表幅度比域，与标准化测量的多个亚类具有显著正相关，而主成分 1 代表活动时间和距离成分，相关性有限。
活动监测的幅度比可以提供额外的客观信息，补充单侧脑瘫儿童未来研究中实验室手功能评估结果。
NCT04904796（前瞻性注册；注册日期：2021 年 5 月 23 日）。
