A systematic review of clinical assessment tools used to measure feeding intervention results in children with cerebral palsy

Abstract Introduction A number of pre-hospital clinical assessment tools have been developed to triage subjects with acute stroke due to large vessel occlusion (LVO) to a specialised endovascular centre, but their false negative rates remain high leading to inappropriate and costly emergency transfers. Transcranial ultrasonography may represent a valuable pre-hospital tool for selecting patients with LVO who could benefit from rapid transfer to a dedicated centre. Methods Diagnostic accuracy of transcranial ultrasonography in acute stroke was subjected to systematic review. Medline, Embase, PubMed, Scopus, and The Cochrane Library were searched. Published articles reporting diagnostic accuracy of transcranial ultrasonography in comparison to a reference imaging method were selected. Studies reporting estimates of diagnostic accuracy were included in the meta-analysis. Results Twenty-seven published articles were selected for the systematic review. Transcranial Doppler findings, such as absent or diminished blood flow signal in a major cerebral artery and asymmetry index ≥ 21% were shown to be suggestive of LVO. It demonstrated sensitivity ranging from 68 to 100% and specificity of 78–99% for detecting acute steno-occlusive lesions. Area under the receiver operating characteristics curve was 0.91. Transcranial ultrasonography can also detect haemorrhagic foci, however, its application is largely restricted by lesion location. Conclusions Transcranial ultrasonography might potentially be used for the selection of subjects with acute LVO, to help streamline patient care and allow direct transfer to specialised endovascular centres. It can also assist in detecting haemorrhagic lesions in some cases, however, its applicability here is largely restricted. Additional research should optimize the scanning technique. Further work is required to demonstrate whether this diagnostic approach, possibly combined with clinical assessment, could be used at the pre-hospital stage to justify direct transfer to a regional thrombectomy centre in suitable cases.

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Reliability and validity of a computer game-based tool of upper extremity assessment for object manipulation tasks in children with cerebral palsy

Journal of Rehabilitation and Assistive Technologies Engineering ◽

10.1177/20556683211014023 ◽

2021 ◽

Vol 8 ◽

pp. 205566832110140

Author(s):

Anuprita Kanitkar ◽

Sanjay T Parmar ◽

Tony J Szturm ◽

Gayle Restall ◽

Gina Rempel ◽

...

Keyword(s):

Cerebral Palsy ◽

Upper Extremity ◽

Performance Measures ◽

Assessment Tool ◽

Computer Game ◽

Object Manipulation ◽

Manual Dexterity ◽

Assessment Tools ◽

Significant Difference ◽

Children With Cerebral Palsy

Introduction A computer game-based upper extremity (CUE) assessment tool is developed to quantify manual dexterity of children with Cerebral Palsy (CP). The purpose of this study was to determine test-retest reliability of the CUE performance measures (success rate, movement onset time, movement error, and movement variation) and convergent validity with the Peabody Developmental Motor Scale version 2 (PDMS-2) and the Quality of Upper Extremity Skills Test (QUEST). Methods Thirty-five children with CP aged four to ten years were tested on two occasions two weeks apart. Results CUE performance measures of five chosen object manipulation tasks exhibited high to moderate intra-class correlation coefficient (ICC) values. There was no significant difference in the CUE performance measures between test periods. With few exceptions, there was no significant correlation between the CUE performance measures and the PDMS-2 or the QUEST test scores. Conclusions The high to moderate ICC values and lack of systematic errors indicate that the CUE assessment tool has the ability to repeatedly record reliable performance measures of different object manipulation tasks. The lack of a correlation between the CUE and the PDMS-2 or QUEST scores indicates that performance measures of these assessment tools represent distinct attributes of manual dexterity.

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