DEVELOPMENT AND RELIABILITY OF AN INSTRUMENTED ASSESSMENT PROTOCOL FOR UPPER LIMB MOVEMENTS IN DYSKINETIC CEREBRAL PALSY

Abstract

Lackness of objective measurements in the upper limb movement impairments makes it more difficult for therapy evaluation and rehabilitation to manage the dyskinetic cerebral palsy (DCP). Uncontrollable movements and unpredictability that reflect choreoathetosis and dystonia are not fully described and explained by clinical rating scales. To develop and evaluate an Instrumented Dystonia and Choreoathetosis Assessment (IDCA) procedure that analyzes upper limb movement in children and young people with DCP by combining three-dimensional optometric motion capture with inertial measurement units (IMUs). Three functional upper limb tasks, such as reach-to-grasp vertically, reaching forward, and reaching sideways, are responsible for making up the IDCA protocol. A multi-camera optometric system was used to chart the upper limb kinematics. Synchronized IMUs were used to record acceleration and segmental angular velocity. The coefficient of multiple correlation (CMC) was employed to assess the consistency of acceleration, joint kinematics, and angular velocity waveforms across and between all sessions. Optometric equipment demonstrated good to exceptional reliability within and between sessions for upper limb joints. IMU-derived angular velocity demonstrated greater consistency and provided moderate to good reliability compared with acceleration-based measurements. It has been observed that reliability was usually higher within sessions than between sessions. The IDCA protocol provides a comprehensive, practical, and trustworthy objective measurement of upper limb movement characteristics in DCP patients. It provides a potential opportunity for intervention monitoring and clinical evaluation supported by complementary data from IMUs and optometric motion capture.