Coordination of Reaching in Children with Spastic Hemiparetic Cerebral Palsy under Different Task Demands

Abstract

Coordination of reaching with the impaired and non-impaired arm in 10 children with spastic hemiparetic cerebral palsy (SHCP) was examined in a stationary ball and moving ball context. Kinematic data on trunk, arm, and wrist movements, and coordination patterns between joint angles of elbow, shoulder, and trunk, were analyzed to determine how reaching was influenced by impairment and object motion. Results showed longer deceleration time and movement time and greater trunk contribution following decreased elbow and shoulder excursion when reaching with the impaired arm compared to the non-impaired arm. The coordination of joint angle pairs showed little linearity for the impaired arm, indicating more segmented movements of shoulder and elbow. It was also found that coordination patterns between elbow, shoulder, and trunk displayed less similarity when reaching with the impaired arm compared to the non-impaired arm in both stationary and moving ball conditions. Regardless of the timing constraints, children with SHCP could make successful interceptions using the impaired arm, indicating that they coordinated and controlled the degrees of freedom within their own functional possibilities.

The Cerebral Palsy Kinematic Assessment Tool (CPKAT): feasibility testing of a new portable tool for the objective evaluation of upper limb kinematics in children with cerebral palsy in the non-laboratory setting

“…In the tracing task, there was a significant difference between the arms for path length, with the non-affected arm tracing a path over a fifth shorter than the affected arm. Our findings are consistent with previous reports within the literature of reduced performance in the affected arm of children with unilateral cerebral palsy 2,3 .…”

“…We postulated that the Culmer et al 25 tasks could be adapted for children with CP and produce similar kinematic measures as previous laboratory based studies 2,3,20 . We This feasibility study was designed to: (i) test the capability of CPKAT to capture high quality kinematic data in a non-laboratory setting; (ii) compare the findings to previous kinematic evaluations in the CP population; (iii) investigate whether CPKAT could detect differences between the impaired and unimpaired arms of children with unilateral CP.…”

“…Impairment of upper limb movements, characterized by increased trajectory duration, reduced speed (peak and average), increased variability and less straight hand trajectories [2][3][4] , is present in up to 80% of children with CP 5 . Upper limb difficulties can cause activity limitation for children with CP (where activity is defined as the execution of a task by an individual 6 ).…”

Interception of moving objects while walking in children with Spastic Hemiparetic Cerebral Palsy

“…The differences in the reach movements of the nonimpaired arm compared to the impaired arm are characterized by some of the typical movement limitations imposed by SHCP. For example, it is often reported that there is less elbow excursion accompanied with more trunk involvement, as well as lower velocity movements when using the impaired arm compared to the non-impaired arm [2].…”

Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy

“…Impairment of upper limb movements, characterized by increased duration, reduced peak velocity, increased variability and less straight hand trajectories [2][3][4] , is present in up to 80% of children with cerebral palsy. Upper limb difficulties cause activity limitation for children with cerebral palsy, activity being defined as the execution of a task or action by an individual 6 .…”