We studied the effect of botulinum toxin A injections to the lower extremities of spastic cerebral palsy children on upper limb body function and occupational performance. A total of 16 children with spastic cerebral palsy, aged 2 to 8 years, Gross Motor Function Classification System levels I-IV, referred to a child neurology outpatient clinic for botulinum toxin A injections to the lower limbs, underwent 4 assessments: 1 month prior to injection, immediate pre injection, and at 1 and 5 to 6 months post injection. Three tools were used to test everyday function (Canadian Occupational Performance Measure and the Pediatric Evaluation of Disability Inventory) and upper extremity body function (Quality of Upper Extremity Skills Test). Significant improvement was documented between the immediate preinjection and the 2 postinjection assessments, indicating that improvement lasted for at least 6 months. Botulinum toxin A injections to the lower extremities in children with cerebral palsy improve upper limb body function and occupational performance.

Clinically feasible assessment of self-feeding is important for adults and children with motor impairments such as stroke or cerebral palsy. However, no validated assessment tool for self-feeding kinematics exists. This work presents an initial validation of an instrumented spoon (DataSpoon) developed as an evaluation tool for self-feeding kinematics. Ten young, healthy adults (three male; age 27.2 ± 6.6 years) used DataSpoon at three movement speeds (slow, comfortable, fast) and with three different grips: “natural”, power and rotated power grip. Movement kinematics were recorded concurrently using DataSpoon and a magnetic motion capture system (trakSTAR). Eating events were automatically identified for both systems and kinematic measures were extracted from yaw, pitch and roll (YPR) data as well as from acceleration and tangential velocity profiles. Two-way, mixed model Intraclass correlation coefficients (ICC) and 95% limits of agreement (LOA) were computed to determine agreement between the systems for each kinematic variable. Most variables demonstrated fair to excellent agreement. Agreement for measures of duration, pitch and roll exceeded 0.8 (excellent agreement) for >80% of speed and grip conditions, whereas lower agreement (ICC < 0.46) was measured for tangential velocity and acceleration. A bias of 0.01–0.07 s (95% LOA [−0.54, 0.53] to [−0.63, 0.48]) was calculated for measures of duration. DataSpoon enables automatic detection of self-feeding using simple, affordable movement sensors. Using movement kinematics, variables associated with self-feeding can be identified and aid clinical reasoning for adults and children with motor impairments.

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Many children with cerebral palsy (CP) encounter great difficulties mastering self-feeding. We set out to assess the self-feeding skills of young children with CP via a novel instrumented spoon that monitors upper extremity biomechanics involved in eating. We describe the initial stages of an iterative design process, consisting of a focus group with domain experts, and rapid-prototyping. We discuss the physical, assessment and safety requirements for the spoon. In addition, we explain the potential of tangible interfaces to provide professional caregivers with valuable information regarding each child.

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