Hedberg-Graff Jenny, Bezuidenhout Lucian, Krumlinde-Sundholm Lena, Hallgren Jenny, Moulaee Conradsson David, Hagströmer Maria
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
Disabil Rehabil. 2025 May;47(9):2436-2442. doi: 10.1080/09638288.2024.2393801. Epub 2024 Aug 27.
To evaluate the association between upper-limb (UL) clinical tests and UL accelerometry-derived metrics in children with unilateral Cerebral Palsy (CP).
In this cross-sectional study, twenty children with unilateral CP and Manual Ability Classification System level I-III were included. Outcomes of the Assisting Hand Assessment, Box and Block-Test and accelerometry metrics were collected in the clinical setting and in daily life. UL asymmetry index (i.e., the ratio between the well-functioning UL and the affected UL use) was evaluated in different physical activity levels and relative use of UL was evaluated during daily living. Spearman's correlation was used to determine the association between UL clinical tests and accelerometry metrics in a clinical setting and in daily life.
The strongest negative association was between the Assisting Hand Assessment units and accelerometry metrics during the sedentary time in daily life (r = -0.64). The asymmetries between ULs were highest during the child's sedentary time (asymmetry index: 45.15) compared to when the child was in light (asymmetry index: 23.97) or higher intensity physical activity (asymmetry index: 13.39). The children used both ULs simultaneously for 44% of the time during daily life.
Accelerometry metrics may provide additional objective information to clinical tests by quantifying the amount of UL movements and the amount of asymmetry between the upper limbs in daily life.
评估单侧脑瘫（CP）患儿上肢（UL）临床试验与基于加速度计得出的UL指标之间的关联。
在这项横断面研究中，纳入了20名单侧CP且手动能力分类系统为I - III级的儿童。在临床环境和日常生活中收集辅助手评估、箱框测试的结果以及加速度计指标。在不同身体活动水平下评估UL不对称指数（即功能良好的UL与受影响的UL使用情况之比），并在日常生活中评估UL的相对使用情况。采用Spearman相关性分析来确定临床环境和日常生活中UL临床试验与加速度计指标之间的关联。
在日常生活中的久坐时间内，辅助手评估得分与加速度计指标之间的负相关性最强（r = -0.64）。与儿童处于轻度（不对称指数：23.97）或高强度身体活动时（不对称指数：13.39）相比，儿童久坐时UL之间的不对称性最高（不对称指数：45.15）。在日常生活中，儿童有44%的时间同时使用双侧UL。
加速度计指标可通过量化日常生活中UL的运动量和上肢之间的不对称程度，为临床试验提供额外的客观信息。
