Actigraph assessment for measuring upper limb activity in unilateral cerebral palsy

I could easily see this objectively measuring the stroke disabled arm so protocols could be mapped fixing specific disabilities. 

Actigraph assessment for measuring upper limb activity in unilateral cerebral palsy

• Elena Beani,
• Martina Maselli,
• Elisa Sicola,
• Silvia Perazza,
• Francesca Cecchi,
• Paolo Dario,
• Irene Braito,
• Roslyn Boyd,
• Giovanni Cioni and
• Giuseppina SgandurraEmail authorView ORCID ID profile

Journal of NeuroEngineering and Rehabilitation201916:30

https://doi.org/10.1186/s12984-019-0499-7

©  The Author(s). 2019

• Received: 13 September 2018
• Accepted: 11 February 2019
• Published: 22 February 2019

Abstract

Background

Detecting differences in upper limb use in children with unilateral cerebral palsy (UCP) is challenging and highly dependent on examiner experience. The recent introduction of technologies in the clinical environment, and in particular the use of wearable sensors, can provide quantitative measurement to overcome this issue.

This study aims to evaluate ActiGraph GT3X+ as a tool for measuring asymmetry in the use of the two upper limbs (ULs) during the assessment with a standardized clinical tool, the Assisting Hand Assessment (AHA) in UCP patients aged 3–25 years compared to age-matched typically developing (TD) subjects.

Methods

Fifty children with UCP and 50 TD subjects were assessed with AHA while wearing ActiGraphs GT3X+ on both wrists. The mean activity of each hand (dominant and non-dominant, MA_DH and MA_NDH, respectively) and the asymmetry index (AI) were calculated. Two linear mixed model analyses were carried out to evaluate how dependent actigraphic variables (i.e. MA_NDH and AI) varied by group (TD vs UCP) and among levels of manual ability based on Manual Ability Classification System (MACS). In both models age, sex, side of hemiplegia, presence/absence of mirror movements were specified as random effects.

Results

The MA_NDH was significantly lower in UCP compared to TD, while the AI was significantly higher in UCP compared to TD. Moreover, in UCP group there were significant differences related to MACS levels, both for MA_NDH and AI.

None of the random variables (i.e. age, sex, side, presence/absence of mirror movements) showed significant interaction with MA_NDH and AI.

Conclusions

These results confirm that actigraphy could provide, in a standardized setting, a quantitative description of differences between upper limbs activity.

Trial registration

ClincalTrials.gov, NCT03054441. Registered 15 February 2017.