Abstract：
Assessment of bimanual movements, which are frequently impaired in children with cerebral palsy, is highly challenging in clinical practice. Instrumented measures have been developed to evaluate and help to understand impaired upper limb movement during bimanual tasks in these children. The aim of this review was to report instrumented measurement tools (3D motion analysis, sensors, etc.) used for bimanual task movement analysis, and the metrological properties of the measures in children with cerebral palsy.
A systematic review was conducted (Prospero CRD42022308517). PubMed, Web of Science, Cochrane and Scopus databases were searched with relevant keywords and inclusion/exclusion criteria. Article quality and biomechanical methods were evaluated with a customized scale and metrological properties with the COSMIN checklist.
In total, 452 children, mostly with unilateral cerebral palsy, mean age 10.9 (SD 3.2) years, underwent quantitative bimanual assessments in the 31 included studies (mean quality score 22/32 points [SD 4.7]). The tools used were 3D motion analysis (n = 26), accelerometers (n = 2), and other instruments (cube, digitizer, etc.) (n = 3). Children performed 1-5 bimanual tasks in laboratory settings, mostly activities of daily living or game scenarios. Analyses focused mostly on spatiotemporal variables, 6 of which were specifically developed for bilateral measures (task completion time, goal synchronization, movement overlap time, interlimb coupling, continuous relative phase and asynchrony). These instrumented measurements had moderate to good discriminant and convergent validity, but reliability and responsiveness assessments were lacking.
A large number of quantitative bimanual assessments involving different tools, bimanual tasks and specific variables developed to evaluate bimanual function were found. Development of other relevant variables and validation of these tools are needed to further determine their usefulness, both as research outcomes and to guide therapies in clinical practice. Future research, involving younger children and real-life assessments, will improve our understanding of bimanual function in children with cerebral palsy.
A systematic review was conducted (Prospero CRD42022308517). PubMed, Web of Science, Cochrane and Scopus databases were searched with relevant keywords and inclusion/exclusion criteria. Article quality and biomechanical methods were evaluated with a customized scale and metrological properties with the COSMIN checklist.
In total, 452 children, mostly with unilateral cerebral palsy, mean age 10.9 (SD 3.2) years, underwent quantitative bimanual assessments in the 31 included studies (mean quality score 22/32 points [SD 4.7]). The tools used were 3D motion analysis (n = 26), accelerometers (n = 2), and other instruments (cube, digitizer, etc.) (n = 3). Children performed 1-5 bimanual tasks in laboratory settings, mostly activities of daily living or game scenarios. Analyses focused mostly on spatiotemporal variables, 6 of which were specifically developed for bilateral measures (task completion time, goal synchronization, movement overlap time, interlimb coupling, continuous relative phase and asynchrony). These instrumented measurements had moderate to good discriminant and convergent validity, but reliability and responsiveness assessments were lacking.
A large number of quantitative bimanual assessments involving different tools, bimanual tasks and specific variables developed to evaluate bimanual function were found. Development of other relevant variables and validation of these tools are needed to further determine their usefulness, both as research outcomes and to guide therapies in clinical practice. Future research, involving younger children and real-life assessments, will improve our understanding of bimanual function in children with cerebral palsy.
摘要：
背景：评估双手运动，脑瘫儿童经常受损，在临床实践中极具挑战性。已开发出仪器化的措施，以评估和帮助了解这些儿童在双手任务中上肢运动受损的情况。本次审查的目的是报告仪器测量工具(3D运动分析，传感器,等。)用于双任务运动分析，以及脑瘫儿童测量的计量特性。
方法：进行系统评价（ProsperoCRD42022308517）。PubMed,WebofScience,使用相关关键词和纳入/排除标准搜索Cochrane和Scopus数据库。使用COSMIN检查表，通过定制的量表和计量性能评估文章质量和生物力学方法。
结果：总计，452名儿童主要是单侧脑瘫，平均年龄10.9（SD3.2）岁，在纳入的31项研究中接受了定量的双向评估(平均质量评分22/32分[SD4.7]).使用的工具是3D运动分析(n=26)，加速度计（n=2），和其他仪器(立方体，数字化仪,等。)(n=3)。孩子们在实验室环境中执行了1-5个双重任务，主要是日常生活活动或游戏场景。分析主要集中在时空变量上，其中6个是专门为双边措施制定的(任务完成时间，目标同步,运动重叠时间,肢体间耦合，连续相对相位和异步)。这些仪器测量具有中等到良好的判别和收敛有效性，但缺乏可靠性和响应性评估.
结论：涉及不同工具的大量定量双向评估，发现了用于评估双函数的双函数任务和特定变量。需要开发其他相关变量并验证这些工具，以进一步确定其有用性，既作为研究结果，又作为临床实践中的指导治疗方法。未来的研究，包括年幼的孩子和现实生活中的评估，将提高我们对脑瘫儿童双功能的认识。
方法：进行系统评价（ProsperoCRD42022308517）。
结果：总计，
结论：涉及不同工具的大量定量双向评估，
