E Ramos1, M P Latash, E A Hurvitz, S H Brown. 1. Department of Physical Medicine, Rehabilitation and Sport Sciences, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico.
Abstract
OBJECTIVE: To illustrate the applicability of motor control analytical techniques to the assessment of upper limb dysfunction in children with ataxia. DESIGN: Descriptive case series. SETTING: The study sample was selected from an outpatient pediatric rehabilitation clinic and testing was performed in a research laboratory. PARTICIPANTS: Four children with upper limb ataxia and seven healthy children were examined. All subjects were recruited on a volunteer basis. Criteria for inclusion (ataxic group) included: (1) age 6 to 15 yrs; (2) ambulatory with assistive devices. MAIN OUTCOME MEASURES: Quantitative measures of elbow kinematics (movement speed and duration) and spatio-temporal "portraits" of elbow movement during unilateral and bilateral forward reaching movements. RESULTS: Movements made by ataxic subjects were characterized by lower peak velocities, prolonged durations, and increased variability compared with normal subjects. In the one subject with unilateral ataxia, interlimb coordination was severely disrupted during the performance of coupled, bilateral arm movements. In addition to changes in specific kinematic values (eg, peak velocity), phase plane and angle-angle displacement curves revealed marked spatio-temporal variability throughout the movement, the magnitude of which was correlated with severity of ataxia. CONCLUSION: The application of the quantitative motor control methods described in this report can provide rehabilitation specialists with a simple yet sensitive means to evaluate treatment and progression of a wide variety of motor disorder conditions. These techniques are particularly well suited to pediatric populations as young as 6 years.
OBJECTIVE: To illustrate the applicability of motor control analytical techniques to the assessment of upper limb dysfunction in children with ataxia. DESIGN: Descriptive case series. SETTING: The study sample was selected from an outpatient pediatric rehabilitation clinic and testing was performed in a research laboratory. PARTICIPANTS: Four children with upper limb ataxia and seven healthy children were examined. All subjects were recruited on a volunteer basis. Criteria for inclusion (ataxic group) included: (1) age 6 to 15 yrs; (2) ambulatory with assistive devices. MAIN OUTCOME MEASURES: Quantitative measures of elbow kinematics (movement speed and duration) and spatio-temporal "portraits" of elbow movement during unilateral and bilateral forward reaching movements. RESULTS: Movements made by ataxic subjects were characterized by lower peak velocities, prolonged durations, and increased variability compared with normal subjects. In the one subject with unilateral ataxia, interlimb coordination was severely disrupted during the performance of coupled, bilateral arm movements. In addition to changes in specific kinematic values (eg, peak velocity), phase plane and angle-angle displacement curves revealed marked spatio-temporal variability throughout the movement, the magnitude of which was correlated with severity of ataxia. CONCLUSION: The application of the quantitative motor control methods described in this report can provide rehabilitation specialists with a simple yet sensitive means to evaluate treatment and progression of a wide variety of motor disorder conditions. These techniques are particularly well suited to pediatric populations as young as 6 years.