The aim of this pilot study was to determine the feasibility and
use accelerometers before, during, and after a camp-based constraint-induced
movement therapy (CIMT) program for children with hemiplegic cerebral palsy.
METHODS:
A pre-test post-test design was used for 12 children with CP
(mean = 4.9 yrs) who completed a 30-hour camp-based CIMT program. The
accelerometer data were collected using ActiGraph GT9X Link. Children wore
accelerometers on both wrists one day before and after the camp and on the
affected limb during each camp day. Three developmental assessments were
administered pre-post CIMT program.
RESULTS:
Accelerometers were successfully worn before, during, and directly
after the CIMT program to collect upper limb data.
Affected upper limb accelerometer activity significantly increased during the CIMT camp compared to baseline (p< 0.05). Significant improvements were seen in all
twelve children on all assessments of affected upper limb function (p< 0.05)
measuring capacity and quality of affected upper limb functioning.
CONCLUSION:
Accelerometers can be worn during high intensity pediatric CIMT
programs to collect data about affected upper limb function. Further study
is required to determine the relationship between accelerometer data,
measure of motor capacity, and real-world performance post-CIMT.
NovakI, McintyreS, MorganC, CampbellL, DarkL, MortanN, StumblesE, WilsonS, GoldsmithL. A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine and Child Neurology. 2013; 55: 885-910.
2.
SakzewskiL, GordonA, EliassonAC. The state of the evid- ence for intensive upper limb therapy approaches for children with unilateral cerebral palsy. Journal of Child Neurology. 2014; 29(8): 1077-1090. doi: 10.1177/0883073814533150.
3.
KolobeT, ChristyJ, GannottiM, HeathcockJ, DamianoD, TaubE, MajsakM, GordonA, FuchsR, O'NeilM, CaiozzoV. Research summit III proceedings on dosing in children with an injured brain or cerebral palsy: executive summary. Physical Therapy. 2014; 94(7): 907-920.
4.
TaubE, RameySL, DeLucaSC, EcholsK. Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics. 2004; 113: 305-312.
5.
DelucaSC, EcholsK, LawCR, RamseySL. Intensive pediatric constraint-induced therapy for children with cerebral palsy: randomized, controlled, crossover trial. Journal of Child Neurology. 2006; 21: 931-938.
6.
HolsbeekeL, KetelaarM, SchoemakerM, GorterJ. Capacity, capability, and performance: Different constructs or three of a kind?Archives of Physical Medicine and Rehabilitation. 2009; 90: 849-855.
7.
SmitsD, GorterJ, SchieP, DallmeijerA, KetelaarM. How do changes in motor capacity, motor capability, and motor performance relate in children and adolescents with cerebral palsy?Archives of Physical Medicine and Rehabilitation. 2014; https://dx-doi-org.web.bisu.edu.cn/j.apmr.2014.04.013.
8.
EladD, BarakS, EisensteinE, BarO, GivonU, BreznerA. Discrepancies between mothers and clinicians in assessing functional capabilities and performance of children with cerebral palsy. Res Dev Disabil. 2013; 34(11): 3746-3753.
9.
WallenM, StewartK. Upper limb function in everyday life of children with cerebral palsy: description and review of parent report measures. Disabil Rehabilitation. 2015; 37(15): 1353-1361.
10.
BaileyR, KlaesnerJ, LangC. Quantifying real-world upper-limb activity in nondisabled adults and adults with chronic stroke. Neurorehabilitation and Neural Repair. 2015; 29(10): 969-978. doi: 10.1177/1545968315583720.
11.
FulkG, CombsS, DanksK, NiriderC, RajaB, ReismanD. People with stroke and traumatic brain injury accuracy of 2 activity monitors in detecting steps in people in stroke and traumatic brain injury. Physical Therapy. 2014; 94: 222-229.
12.
UswatteG, FooWL, OlmsteadH, LopezK, HolandA, SimmsLB. Ambulatory monitoring of arm movement using accelerometry: An objective measure of upper-extremity rehabilitation in persons with chronic stroke. Archives of Physical Medicine and Rehabilitation. 2005; 86, 1498-1501. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.apmr.2005.01.010.
13.
UswatteG, GiulianiC, WinsteinC, ZeringueA, HobbsL, Wolf,SL. Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke: Evidence from the extremity constraintinduced therapy evaluation trial. Archives of Physical Medicine and Rehabilitation. 2006; 87, 1340-1345. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.apmr.2006.06.006.
14.
UswatteG, MiltnerW, FooB, VarmaM, MoranS, TaubE. Objective measurement of functional upper-extremity movement using accelerometer recordings transformed with a threshold filter. Stroke. 2000 Mar; 31(3): 662-667.
15.
ButteNF, WongWW, LeeJS, AdolphAL, PuyauMR, ZakeriIF. Prediction of energy expenditure and physical activity in preschoolers. Med Sci Sports Exerc. 2014; 46(6): 1216-1226. doi: 10.1249/MSS.0000000000000209.
16.
CapioCM, SitCH, AbernethyB. Physical activity measurement using MTI (Actigraph) among children with cerebral palsy. Arch Phys Med Rehabil. 2010; 91(8): 1283-1290.
17.
PatelS, ParkH, BonatoP, ChanL, RodgersMJ. A review of wearable sensors and systems with application in rehabilitation. Neuroengineering and Rehabilitation. 2012; 20: 9-21. doi: 10.1186/1743-0003-9-21.
18.
ClanchyK, TweedyS, BoydR, TrostS. Validity of accelerometry in ambulatory children and adolescents with cerebral palsy. European Journal of Applied Physiology. 2011; 111(12): 2951-2959.
O'NeilM, Fragala-PinkhamM, FormanJ, TrostS. Measuring reliability and validity of the ActiGraph GT3X accelerometer for children with cerebral palsy: a feasibility study. J Pediatr Rehabil Med. 2014; 7(3): 233-240. doi: 10.3233/PRM-140292.
21.
O'NeilM, Fragala-PinkhamM, LennonN, GeorgeA, FormanJ, TrostS. Reliability and Validity of Objective Measures of Physical Activity in Youth With Cerebral Palsy Who Are Ambulatory. Phys Ther. 2016 Jan; 96(1): 37-45. doi: 10.2522/ptj.20140201. Epub 2015 Jun 18.
22.
EliassonA, Krumlinde-SundholmL, RosbladB, BeckungE, ArnerM, OhrvallA, RosenbaumP. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity, and reliability. Dev Med Child Neurology. 2006; 48(7): 549-5423.
23.
CokerP, KarakostasT, DoddsC, HsiangS. Gait characteristics of children with hemiplegic cerebral palsy before and after modified constraint-induced movement therapy. Disability and Rehabilitation. 2010; 32(5): 402-408.
24.
AartsPB, JongeriusPH, GeerdinkYA, van LimbeekJ, GeurtsAC. Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial. Neurorehabilitation and Neural Repair. 2010; 24(6): 509-518. doi: 10.1177/15459683093 59767.
25.
EliassonAC, Krumlinde-sundholmL, ShawK, WangC. Effects of constraint-induced movement therapy in young children with hemiplegic cerebral palsy: an adapted model. Developmental Medicine and Child Neurology. 2005; 47(4): 266-275.
26.
EliassonAC, ShawK, BergE, Krumlinde-SundholmL. An ecological approach of Constraint Induced Movement Therapy for 2-3-year-old children: a randomized control trial. Research in Developmental Disability. 2011; 32(6): 2820-2828. doi: 10.1016/j.ridd.2011.05.024.
27.
RandallM, CarlinJB, ChondrosP, ReddihoughD. Reliability of the Melbourne assessment of unilateral upper limb function. Dev Med Child Neurology. 2014; 43(11): 761-767.
28.
SpirtosM, O'MahonyP, MaloneJ. Interrater reliability of the Melbourne Assessment of Unilateral Upper Limb Function for children with hemiplegic cerebral palsy. Am J Occup Therapy. 2011; 65(4): 378-383.
29.
KlingelsK, De CockP, DesloovereK, et al. Comparison of the Melbourne assessment of unilateral upper 546. Developmental Medicine & Child Neurology. 2015; 57: 539-547.
30.
KlingelsK, De CockP, DesloovereK, et al. Limb function and the quality of upper extremity skills test in hemiplegic CP. Dev Med Child Neurol. 2008; 50: 904-909.
31.
WagnerLV, DavidsJR. Assessment tools and classification systems used for the upper extremity in children with cerebral palsy. Clin Orthop Relat Res. 2012; 470(5): 1257-1271.
32.
SkoldA, HermanssonL, Krumlinde-SundholmL, EliassonA. Development and evidence of validity for the Children's Hand-use Experience Questionnaire (CHEQ). Developmental Medicine & Child Neurology. 2011; 53(5): 436-44233.
33.
HaleyS, CosterW, LudlowL, HaltiwangerJ, AndrellosP. Pediatric Evaluation of Disability Inventory (PEDI). Version 1.0. Boston: New England Medical Center Hospitals. 1992.
34.
HaleyS, CosterW, FaasR. A content validity study of the Pediatric Evaluation of Disability Inventory. Pediatr Phys Therapy. 1991; 4: 177-184.
35.
FoweatherL, KnowlesZ, RodgersN, O'DwyerM, FoulkesJ, StrattonG. Fundamental movement skills in relation to weekday and weekend physical activity in preschool children. Journal of Science Medicine and Sport. 2014; 18(6): 691-696. doi: 10.1016/j.jsams.
36.
OftedalS, BellKL, DaviesPS, WareRS, BoydRN. Sedentary and Active Time in Toddlers with and without Cerebral Palsy. Med Sci Sports Exerc. 2015; 47(10): 2076-2083. doi: 10.1249/MSS.0000000000000653.
37.
SakzewskiL, ZivianiJ, AbbottDF, MacdonellRA, JacksonGD, BoydRN. Participation outcomes in a randomized trial of 2 models of upper-limb rehabilitation for children with congenital hemiplegia. Archives of Physical Medicine and Rehabilitation. 2001a; 92: 531-539.
38.
KlingelsK, De CockP, DesloovereK, HuenaertsC, MolenaersG, Van NulandI, FeysH. Comparison of the Melbourne Assessment of Unilateral Upper Limb Function and the Quality of Upper Extremity Skills Test in hemiplegic CP. Developmental Medicine and Child Neurology. 2008; 50: 904-909.
39.
de Brito BrandãoM, ManciniMC, VazDV, Pereira de MeloAP, FonsecaST. Adapted version of constraint-induced movement therapy promotes functioning in children with cerebral palsy: A randomized controlled trial. Clinical Rehabilitation. 2010; 24: 639-647.
40.
SakzewskiL, ProvanK, ZivianiJ, BoydR. Comparison of dosage of intensive upper limb therapy for children with unilateral cerebral palsy: How big should the therapy pill be?Research In Developmental Disabilities. 2015; 37: 9-16.
41.
SokalB, UsatteG, VogtleL, ByromE, BarmanJ. Everyday movement and use of the arms: Relationship in children with hemiparesis differs from adults. Journal of Pediatric Rehabilitation and Medicine. 2015; 8: 197-206.
42.
MitchellL, ZivianiJ, BoydR. Variability in measuring physical activity in children with cerebral palsy. Medicine and Science in Sports Exercise. 2015; 47(1): 194-200, DOI: 10.1249/MSS.0000000000000374.
43.
DomanC, WaddellK, BaileyR, MooreJ, LangC. Changes in upper-extremity functional capacity and daily performance during outpatient occupational therapy for people with stroke. American Journal of Occupational Therapy. 2016; 70(3): 7003290040p1-7003290040p11.
