Development of a home-based wrist range-of-motion training system for children with cerebral palsy

AbstractThis paper presents the proof-of-concept of a home-based gamified wrist rehabilitation training system for children with cerebral palsy (CCP). We describe the user-centered design process of this system, which is composed of a wrist-worn inertial measurement unit (IMU) and a tangible device with an embedded IMU. The system employs a quaternion-based algorithm for automatic real-time estimation of the range of motion (RoM) covered by adduction/abduction and flexion/extension motions of the wrist. Experimental validation shows that the RoM can be determined with sufficient accuracy to control a game and that the algorithm is applicable in CCP. A serious game, which uses the presented algorithm and enables feedback as well as motivating stimuli, is implemented and evaluated by physiotherapists.

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Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy

Diagnostics ◽

10.3390/diagnostics10090661 ◽

2020 ◽

Vol 10 (9) ◽

pp. 661

Author(s):

Cristina Carmona-Pérez ◽

Alberto Pérez-Ruiz ◽

Juan L. Garrido-Castro ◽

Francisco Torres Vidal ◽

Sandra Alcaraz-Clariana ◽

...

Keyword(s):

Cerebral Palsy ◽

Motor Control ◽

Inertial Measurement Unit ◽

Measurement Unit ◽

Validity And Reliability ◽

Inertial Measurement ◽

Functional Measures ◽

Flexion Extension ◽

Children With Cerebral Palsy ◽

Cervical Posture

Objective: The aim of this study was to design and propose a new test based on inertial measurement unit (IMU) technology, for measuring cervical posture and motor control in children with cerebral palsy (CP) and to evaluate its validity and reliability. Methods: Twenty-four individuals with CP (4–14 years) and 24 gender- and age-matched controls were evaluated with a new test based on IMU technology to identify and measure any movement in the three spatial planes while the individual is seated watching a two-minute video. An ellipse was obtained encompassing 95% of the flexion/extension and rotation movements in the sagittal and transversal planes. The protocol was repeated on two occasions separated by 3 to 5 days. Construct and concurrent validity were assessed by determining the discriminant capacity of the new test and by identifying associations between functional measures and the new test outcomes. Relative reliability was determined using the intraclass correlation coefficient (ICC) for test–retest data. Absolute reliability was obtained by the standard error of measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90). Results: The discriminant capacity of the area and both dimensions of the new test was high (Area Under the Curve ≈ 0.8), and consistent multiple regression models were identified to explain functional measures with new test results and sociodemographic data. A consistent trend of ICCs higher than 0.8 was identified for CP individuals. Finally, the SEM can be considered low in both groups, although the high variability among individuals determined some high MDC90 values, mainly in the CP group. Conclusions: The new test, based on IMU data, is valid and reliable for evaluating posture and motor control in children with CP.

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Concurrent Validity and Reliability of an Inertial Measurement Unit for the Assessment of Craniocervical Range of Motion in Subjects with Cerebral Palsy

Diagnostics ◽

10.3390/diagnostics10020080 ◽

2020 ◽

Vol 10 (2) ◽

pp. 80 ◽

Cited By ~ 5

Author(s):

Cristina Carmona-Pérez ◽

Juan Luis Garrido-Castro ◽

Francisco Torres Vidal ◽

Sandra Alcaraz-Clariana ◽

Lourdes García-Luque ◽

...

Keyword(s):

Cerebral Palsy ◽

Range Of Motion ◽

Correlation Coefficient ◽

Measurement Unit ◽

Control Group ◽

Validity And Reliability ◽

Inertial Measurement ◽

Flexion Extension ◽

Absolute Reliability ◽

Error Of Measurement

Objective: This study aimed to determine the validity and reliability of Inertial Measurement Units (IMUs) for the assessment of craniocervical range of motion (ROM) in patients with cerebral palsy (CP). Methods: twenty-three subjects with CP and 23 controls, aged between 4 and 14 years, were evaluated on two occasions, separated by 3 to 5 days. An IMU and a Cervical Range of Motion device (CROM) were used to assess craniocervical ROM in the three spatial planes. Validity was assessed by comparing IMU and CROM data using the Pearson correlation coefficient, the paired t-test and Bland–Altman plots. Intra-day and inter-day relative reliability were determined using the Intraclass Correlation Coefficient (ICC). The Standard Error of Measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90) were obtained for absolute reliability. Results: High correlations were detected between methods in both groups on the sagittal and frontal planes (r > 0.9), although this was reduced in the case of the transverse plane. Bland–Altman plots indicated bias below 5º, although for the range of cervical rotation in the CP group, this was 8.2º. The distance between the limits of agreement was over 23.5º in both groups, except for the range of flexion-extension in the control group. ICCs were higher than 0.8 for both comparisons and groups, except for inter-day comparisons of rotational range in the CP group. Absolute reliability showed high variability, with most SEM below 8.5º, although with worse inter-day results, mainly in CP subjects, with the MDC90 of rotational range achieving more than 20º. Conclusions: IMU application is highly correlated with CROM for the assessment of craniocervical movement in CP and healthy subjects; however, both methods are not interchangeable. The IMU error of measurement can be considered clinically acceptable; however, caution should be taken when this is used as a reference measure for interventions.

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Effect of an interval rehabilitation program with home-based, vibration-assisted training on the development of muscle and bone in children with cerebral palsy – an observational study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0080 ◽

2020 ◽

Vol 33 (8) ◽

pp. 1083-1092 ◽

Cited By ~ 1

Author(s):

Ibrahim Duran ◽

Kyriakos Martakis ◽

Christina Stark ◽

Leonie Schafmeyer ◽

Mirko Rehberg ◽

...

Keyword(s):

Cerebral Palsy ◽

Bone Growth ◽

Muscle Growth ◽

Rehabilitation Program ◽

Whole Body ◽

Cross Sectional ◽

Home Based ◽

Children With Cerebral Palsy ◽

One Year ◽

Intensive Rehabilitation

AbstractObjectivesIn children with cerebral palsy (CP), the most common cause of physical impairment in childhood, less muscle and bone growth has been reported, when compared with typically developing children. The aim of this study was to evaluate the effect of an intensive rehabilitation program including physiotherapy in combination with 6 months of home-based, vibration-assisted training on muscle and bone growth in children with CP.MethodsWe included children with CP, who participated in a rehabilitation program utilizing whole-body vibration (WBV). Muscle mass was quantified by appendicular lean mass index (App-LMI) and bone mass by total-body-less-head bone mineral content (TBLH-BMC) assessed by Dual-energy X-ray absorptiometry (DXA) at the beginning of rehabilitation and one year later. To assess the functional muscle-bone unit, the relation of TBLH-BMC to TBLH lean body mass (TBLH-LBM) was used.ResultsThe study population included 128 children (52 females, mean age 11.9 ± 2.7). App-LMI assessed in kg/m2 increased significantly after rehabilitation. The age-adjusted Z-score for App-LMI showed no significant change. TBLH-BMC assessed in gram increased significantly. The Z-scores for TBLH-BMC decreased lesser than expected by the evaluation of the cross-sectional data at the beginning of rehabilitation. The parameter $\frac{TBLH-BMC}{TBLH-LBM}$ did not change relevantly after 12 months.ConclusionsMuscle growth and to a lesser extent bone growth could be increased in children with CP. The intensive rehabilitation program including WBV seemed to have no direct effect on the bone, but the observed anabolic effect on the bone, may only been mediated through the muscle.

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Effectiveness of Virtual Reality and Visual Feedback on Balance and Leg Function in Children with Cerebral Palsy

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v1i18.748 ◽

2019 ◽

Vol 1 (18) ◽

Author(s):

Arūnė Dūdaitė ◽

Vilma Juodžbalienė

Keyword(s):

Virtual Reality ◽

Cerebral Palsy ◽

Postural Control ◽

Range Of Motion ◽

Visual Feedback ◽

Lower Limb ◽

Dynamic Balance ◽

Control Group ◽

Children With Cerebral Palsy ◽

Stretching Exercises

Research background. Virtual reality and visual feedback improve motor performance, motor function and balance, so we want to fnd if it aﬀects the function of legs and balance of children with spastic hemiplegia. Research aim was to establish if the use of virtual reality and visual feedback with traditional physiotherapy improve the function of legs and balance of children with cerebral palsy. Methods. Nine children with cerebral palsy participated in the research. Participants were randomly divided into two groups – virtual reality group (n = 6) and control (n = 3). Virtual reality group practised exergaming and stretching exercises for 10 weeks, twice a week. Control group practiced conventional physiotherapy and stretching exercises for 6 weeks, twice a week. We measured the range of motion of the lower limb, spasticity of the lower limb using Modifed Ashworth’o Scale, static, dynamic balance, trunk coordination using Trunk Impairment Scale at the start and the end of the research, and balance using Pediatric Balance Scale. Results. Virtual reality and visual feedback reduced the spasticity of the lower limb, improved balance and postural control for children with cerebral palsy, but it did not improve the range of motion of the lower limb of children with cerebral palsy. Conclusions. Virtual reality and visual feedback did not improve the range of motion of the lower limb of children with cerebral palsy. Virtual reality and visual feedback reduced spasticity of the lower limb, improved balance and postural control for children with cerebral palsy.Keywords. Cerebral palsy, virtual reality, visual feedback, postural control, muscle architecture.

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A DYNAMIC SEATING SYSTEM FOR CHILDREN WITH CEREBRAL PALSY

Journal of Musculoskeletal Research ◽

10.1142/s0218957709002158 ◽

2009 ◽

Vol 12 (01) ◽

pp. 21-30 ◽

Cited By ~ 3

Author(s):

Michael E. Hahn ◽

Sheri L. Simkins ◽

Jacob K. Gardner ◽

Gaurav Kaushik

Keyword(s):

Cerebral Palsy ◽

Range Of Motion ◽

Motor Function ◽

Control Group ◽

Significant Group ◽

Gross Motor ◽

Gross Motor Function ◽

Muscle Spasticity ◽

Children With Cerebral Palsy ◽

Dynamic Seating

The study's aim was to determine the initial effects of a dynamic seating system as a therapeutic intervention in children with cerebral palsy. A two-factor, repeated-measures design was used. Twelve children with neuromuscular dysfunction (mean age 6.0, SD 2.7 years) were included in the study, randomly assigned to an experimental or a control group. At study initiation the experimental group received a wheelchair with dynamic seating components that allows limited range of motion in the hip and knee, and the control group received a static setting wheelchair. Participants were evaluated for range of motion, muscle spasticity (Modified Ashworth Scale), motor function (Gross Motor Function Measure), and level of disability (Pediatric Evaluation of Disability Inventory) at study initiation, 3-months, and 6-months post intervention. Both groups improved in motor function over time, particularly in the categories of Sitting and Crawl/Kneel. Measures of disability improved in both groups for the categories of self-care, mobility, and social function. A larger, more homogeneous sample would likely show significant group differences in measures of muscle spasticity, gross motor function and disability.

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