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评估单侧脑瘫患儿上肢功能的整体方法:临床工具及综合评估的新兴技术的叙述性综述

A Holistic Approach Towards Evaluating Upper Limb Function in Children with Unilateral Cerebral Palsy: A Narrative Review of Clinical Tools and Promising Technologies for Comprehensive Assessment.

作者信息

De Luca Giovanna, Kalkantzi Alexandra, Mailleux Lisa, Palomo-Carrión Rocío, Feys Hilde, Boyd Roslyn N, Beani Elena, Cianchetti Matteo, Filogna Silvia, Prencipe Giuseppe, Sgandurra Giuseppina, Maselli Martina

机构信息

The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025 Pisa, Italy.

Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025 Pisa, Italy.

出版信息

J Clin Med. 2025 Sep 17;14(18):6539. doi: 10.3390/jcm14186539.

Abstract

Optimal upper limb (UpL) function is essential for performing daily activities; however, children with unilateral spastic cerebral palsy (USCP) often experience impairments in UpL function, which can impact their quality of life or independence. While UpL motor impairments are a primary concern, non-motor functions, such as cognition, attention, and visual function, commonly impaired in USCP, may also play a role in UpL performance. Nevertheless, these non-motor functions are often not considered in evaluation protocols that focus on the UpL. Moreover, clinical evaluation is typically conducted in structured and controlled settings and may not accurately reflect the child's abilities in daily life. Non-invasive, novel technologies are a promising solution for filling this gap, by providing additional quantitative and ecologically valid information to clinicians. In this context, this overview aims (i) to present the most frequently used tools for a holistic evaluation in children with USCP, ensuring a thorough understanding of the UpL function, and (ii) to report the evidence of how novel, non-invasive technologies can enhance clinical evaluation in daily life, enabling a more comprehensive evaluation. This work could set a basis for multidimensional evaluation protocols for UpL function in USCP, providing a different approach to the current standards.

摘要

最佳上肢(UpL)功能对于进行日常活动至关重要;然而,单侧痉挛性脑瘫(USCP)患儿的UpL功能常受损,这会影响他们的生活质量或独立性。虽然UpL运动功能障碍是主要关注点,但USCP中常见的非运动功能,如认知、注意力和视觉功能,也可能对UpL表现产生影响。然而,在专注于UpL的评估方案中,这些非运动功能往往未被考虑。此外,临床评估通常在结构化和受控环境中进行,可能无法准确反映儿童在日常生活中的能力。非侵入性新技术有望填补这一空白,为临床医生提供额外的定量且具有生态效度的信息。在此背景下,本综述旨在:(i)介绍USCP患儿全面评估中最常用的工具,确保对UpL功能有透彻理解;(ii)报告新型非侵入性技术如何能增强日常生活中的临床评估,实现更全面评估的证据。这项工作可为USCP中UpL功能的多维度评估方案奠定基础,提供一种不同于当前标准的方法。

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