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Title: Negative Influence of Motor Impairmentson Upper Limb Movement Patterns in Children with Unilateral Cerebral Palsy. A Statistical Parametric Mapping Study
Authors: Simon-Martinez, Cristina
Jaspers, Ellen
Mailleux, Lisa
Desloovere, Kaat
Vanrenterghem, Jos
Ortibus, Els
Molenaers, Guy
Feys, Hilde
Klingels, Katrijn
Issue Date: 2017
Abstract: Upper limb three-dimensional movement analysis (UL-3DMA) offers a reliable and valid tool to evaluate movement patterns in children with unilateral cerebral palsy (uCP). However, it remains unknown to what extent the underlying motor impairments explain deviant movement patterns. Such understanding is key to develop efficient rehabilitation programs. Although UL-3DMA has been shown to be a useful tool to assess movement patterns, it results in a multitude of data, challenging the clinical interpretation and consequently its implementation. UL-3DMA reports are often reduced to summary metrics, such as average or peak values per joint. However, these metrics do not take into account the continuous nature of the data or the interdependency between UL joints, and do not provide phase-specific information of the movement pattern. Moreover, summary metrics may not be sensitive enough to estimate the impact of motor impairments. Recently, Statistical Parametric Mapping (SPM) was proposed to overcome these problems. We collected UL-3DMA of 60 children with uCP and 60 typically developing children during eight functional tasks and evaluated the impact of spasticity and muscle weakness on UL movement patterns. SPM vector field analysis was used to analyze movement patterns at the level of five joints (wrist, elbow, shoulder, scapula, and trunk). Children with uCP showed deviant movement patterns in all joints during a large percentage of the movement cycle. Spasticity and muscle weakness negatively impacted on UL movement patterns during all tasks, which resulted in increased wrist flexion, elbow pronation and flexion, increased shoulder external rotation, decreased shoulder elevation with a preference for movement in the frontal plane and increased trunk internal rotation. Scapular position was altered during movement initiation, although scapular movements were not affected by muscle weakness or spasticity. In conclusion, we identified pathological movement patterns in children with uCP and additionally mapped the negative impact of spasticity and muscle weakness on these movement patterns, providing useful insights that will contribute to treatment planning. Last, we also identified a subset of the most relevant tasks for studying UL movements in children with uCP, which will facilitate the interpretation of UL-3DMA data and undoubtedly contribute to its clinical implementation.
Notes: [Simon-Martinez, Cristina; Mailleux, Lisa; Desloovere, Kaat; Vanrenterghem, Jos; Feys, Hilde; Klingels, Katrijn] Katholieke Univ Leuven, Dept Rehabil Sci, Leuven, Belgium. [Jaspers, Ellen] Swiss Fed Inst Technol, Neural Control Movement Lab, Zurich, Switzerland. [Desloovere, Kaat] Univ Hosp Leuven, Clin Mot Anal Lab, Leuven, Belgium. [Ortibus, Els; Molenaers, Guy] Katholieke Univ Leuven, Dept Dev & Regenerat, Leuven, Belgium. [Molenaers, Guy] Univ Hosp Leuven, Dept Orthoped Med, Leuven, Belgium. [Klingels, Katrijn] Univ Hasselt, BIOMED, Rehabil Res Ctr REVAL, Diepenbeek, Belgium.
URI: http://hdl.handle.net/1942/25782
DOI: 10.3389/fnhum.2017.00482
ISI #: 000412535100001
ISSN: 1662-5161
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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