Kinematic parameters of hand movement during a disparate bimanual movement task in children with unilateral Cerebral Palsy

Kinematic motion abnormalities and bimanual performance in children with unilateral cerebral palsy

“…Firstly, the population studied was subject to the inclusion and exclusion criteria from the current clinical research project aiming to assess the effect of mirror therapy in children with hemiplegia. Few studies have evaluated the kinematics of the hemiplegic limb in a bimanual situation, 24,25 but none has explored the waveform of the movements by using kinematic indices. Firstly, it is a subjective tool based on a video recording and scored by an operator.…”

The Tyneside Pegboard Test: balancing clinical utility against ecological validity

“…The development of assessments that capture important and relevant information to guide clinical management, describe natural phenomena, and/or depict developmental changes, is a complex and lengthy process. This is all the more so when considering the multifaceted capacities required for bimanual skills which involve not only unimanual functions of reaching, grasping, and in‐hand manipulation, but the additional spatial and temporal synchronization of inter‐limb movements . The majority of currently available assessments of upper limb skills available are either too demanding on hand dexterity or do not address bimanual coordination to determine the impact on bimanual performance in conditions such as bilateral or unilateral cerebral palsy (CP) or hemiparesis .…”

“…The focused approach, however, does allow for discrimination between unimanual versus bimanual capacity by determining differences in the time taken to transfer objects towards or away from the dominant and non‐dominant hands . Future modifications to the TPT could also provide information on the impact of mirrored movements and interference on bimanual coordination in unilateral CP . The simplicity of administration and use of technology to bolster reliability shows promise for the TPT as a useful clinical tool.…”

“…to provide meaning to the test scores. The challenge remains to consider how to integrate multiple factors that are at play in the development of hand function, particularly for children with impairments in motor performance …”

“…4 Future modifications to the TPT could also provide information on the impact of mirrored movements and interference on bimanual coordination in unilateral CP. 2 The simplicity of administration and use of technology to bolster reliability shows promise for the TPT as a useful clinical tool.A word of caution perhaps, with oversimplifying assessments to focus on components of complex skills rather than hand function within daily activities. Recent evidence of the ecological validity of clinical tests (extent to which the tests reflect real life skills) 5 shows that motor performance that may be influenced by other factors such as additional cognitive, perceptual or motivational issues, or environmental contexts, is less likely to be indicative of everyday performance.…”