Catherine R Hoyt1, Shelby K Brown2, Sarah K Sherman2, Melanie Wood-Smith2, Andrew N Van3, Mario Ortega4, Annie L Nguyen3, Catherine E Lang5, Bradley L Schlaggar6, Nico U F Dosenbach7. 1. Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States; Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States. Electronic address: hoytcr@wustl.edu. 2. Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States; Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States. 3. Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States; Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, United States; Washington University School of Medicine, Department of Neuroscience, St. Louis, MO, United States. 4. Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States; Washington University School of Medicine, Department of Neuroscience, St. Louis, MO, United States. 5. Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States; Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States; Washington University School of Medicine, Program in Physical Therapy, St. Louis, MO, United States. 6. Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States; Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, United States; Washington University School of Medicine, Department of Neuroscience, St. Louis, MO, United States; Kennedy Krieger Institute, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD, United States. 7. Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States; Washington University School of Medicine, Department of Neurology, St. Louis, MO, United States; Washington University School of Medicine, Department of Radiology, St. Louis, MO, United States; Washington University School of Medicine, Department of Pediatrics, St. Louis, MO, United States; Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, United States; Washington University School of Medicine, Department of Neuroscience, St. Louis, MO, United States; Washington University School of Medicine, Department of Biomedical Engineering, St. Louis, MO, United States.
Abstract
BACKGROUND: When detected, children with asymmetrical motor impairment are referred for therapeutic interventions to maximize the child's ability to reach their health and developmental potential. Referal is dependent on standardized evaluation, which rarely examines upper extremity (UE) function within the context of real-world activity. Accelerometry provides an efficient method to objectively measure movement in children. The purpose of this study was to compare accelerometry to clinical assessment, specifically the Melbourne Assessment of Unilateral Upper Limb Function-2 (MA-2). METHODS: A total of 52 children between 1-17 years of age with asymmetrical motor deficits and age matched controls participated in this study. Participants wore bilateral accelerometers for 4 x 25 h. The use ratio (UR) and mono-arm use index (MAUI) were calculated to quantify asymmetrical impairment. The Melbourne Assessment of Unilateral Upper Limb Function-2 (MA-2) was administered and compared to accelerometry variables. RESULTS: The UR and MAUI were significantly different in children with and without deficits. The MAUI was significantly correlated with all domains of the MA-2: accuracy (r = 0.44, p = 0.026); fluency (r = 0.52, p = 0.006); dexterity (r = 0.53, p = 0.005); and range of motion (r = 0.49, p = 0.011). CONCLUSIONS: Our findings suggest a relationship between real-world movement and clinical evaluation.
BACKGROUND: When detected, children with asymmetrical motor impairment are referred for therapeutic interventions to maximize the child's ability to reach their health and developmental potential. Referal is dependent on standardized evaluation, which rarely examines upper extremity (UE) function within the context of real-world activity. Accelerometry provides an efficient method to objectively measure movement in children. The purpose of this study was to compare accelerometry to clinical assessment, specifically the Melbourne Assessment of Unilateral Upper Limb Function-2 (MA-2). METHODS: A total of 52 children between 1-17 years of age with asymmetrical motor deficits and age matched controls participated in this study. Participants wore bilateral accelerometers for 4 x 25 h. The use ratio (UR) and mono-arm use index (MAUI) were calculated to quantify asymmetrical impairment. The Melbourne Assessment of Unilateral Upper Limb Function-2 (MA-2) was administered and compared to accelerometry variables. RESULTS: The UR and MAUI were significantly different in children with and without deficits. The MAUI was significantly correlated with all domains of the MA-2: accuracy (r = 0.44, p = 0.026); fluency (r = 0.52, p = 0.006); dexterity (r = 0.53, p = 0.005); and range of motion (r = 0.49, p = 0.011). CONCLUSIONS: Our findings suggest a relationship between real-world movement and clinical evaluation.
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