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An Instrumented Assessment of a Rhythmic Finger Task among Children with Motor Coordination Difficulties.

ABSTRACT: BACKGROUND:Coordination is crucial for motor function, yet objective clinical evaluations are limited. We therefore developed and tested the reliability and validity of a low-cost sensorized evaluation of a rhythmic finger task. METHODS:Children with coordination difficulties (n = 24) and typically developing children (n = 24) aged from 5 to 7 years performed the Sensorized Finger Sequencing Test (SFST), a finger sequencing test that records the correct sequence, total time, and the standard deviation (SD) of touch time. Additionally, motor performance tests and parents' reports were applied in order to test the reliability and validity of the SFST. RESULTS:The study group had significantly greater thumb-finger test scores-total time in the dominant hand (p = 0.035) and the SD of the touch time in both dominant (p = 0.036) and non-dominant (p = 0.032) hands. Motor performance tests were not correlated with the SFST. Test-retest reliability in 10 healthy children was found for the SD of touch time in the dominant hand (r = 0.87, p = 0.003). CONCLUSIONS:The SFST was successful in assessing the movement pattern variability reported in children with motor difficulties. This exploratory study indicates that the low-cost SFST could be utilized as an objective measure for the assessment of proprioception components, which currently are overlooked by standardized motor performance assessments.

SUBMITTER: Keinan A

PROVIDER: S-EPMC7472119 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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An Instrumented Assessment of a Rhythmic Finger Task among Children with Motor Coordination Difficulties.

Keinan Artal A Bar-Shalita Tami T Portnoy Sigal S

Sensors (Basel, Switzerland) 20200814 16

<h4>Background</h4>Coordination is crucial for motor function, yet objective clinical evaluations are limited. We therefore developed and tested the reliability and validity of a low-cost sensorized evaluation of a rhythmic finger task.<h4>Methods</h4>Children with coordination difficulties (<i>n</i> = 24) and typically developing children (<i>n</i> = 24) aged from 5 to 7 years performed the Sensorized Finger Sequencing Test (SFST), a finger sequencing test that records the correct sequence, tot ...[more]

PMID: 32823856

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Project description:BACKGROUND:In this systematic review we investigate which instrumented measurements are available to assess motor impairments, related activity limitations and participation restrictions in children and young adults with dyskinetic cerebral palsy. We aim to classify these instrumented measurements using the categories of the international classification of functioning, disability and health for children and youth (ICF-CY) and provide an overview of the outcome parameters. METHODS:A systematic literature search was performed in November 2019. We electronically searched Pubmed, Embase and Scopus databases. Search blocks included (a) cerebral palsy, (b) athetosis, dystonia and/or dyskinesia, (c) age 2-24 years and (d) instrumented measurements (using keywords such as biomechanics, sensors, smartphone, and robot). RESULTS:Our search yielded 4537 articles. After inspection of titles and abstracts, a full text of 245 of those articles were included and assessed for further eligibility. A total of 49 articles met our inclusion criteria. A broad spectrum of instruments and technologies are used to assess motor function in dyskinetic cerebral palsy, with the majority using 3D motion capture and surface electromyography. Only for a small number of instruments methodological quality was assessed, with only one study showing an adequate assessment of test-retest reliability. The majority of studies was at ICF-CY function and structure level and assessed control of voluntary movement (29 of 49) mainly in the upper extremity, followed by assessment of involuntary movements (15 of 49), muscle tone/motor reflex (6 of 49), gait pattern (5 of 49) and muscle power (2 of 49). At ICF-CY level of activities and participation hand and arm use (9 of 49), fine hand use (5 of 49), lifting and carrying objects (3 of 49), maintaining a body position (2 of 49), walking (1 of 49) and moving around using equipment (1 of 49) was assessed. Only a few methods are potentially suitable outside the clinical environment (e.g. inertial sensors, accelerometers). CONCLUSION:Although the current review shows the potential of several instrumented methods to be used as objective outcome measures in dyskinetic cerebral palsy, their methodological quality is still unknown. Future development should focus on evaluating clinimetrics, including validating against clinical meaningfulness. New technological developments should aim for measurements that can be applied outside the laboratory.

Project description:ObjectivesThe study aims to better understand the rhythmic abilities of people who stutter and to identify which processes potentially are impaired in this population: (1) beat perception and reproduction; (2) the execution of movements, in particular their initiation; (3) sensorimotor integration.Material and methodFinger tapping behavior of 16 adults who stutter (PWS) was compared with that of 16 matching controls (PNS) in five rhythmic tasks of various complexity: three synchronization tasks - a simple 1:1 isochronous pattern, a complex non-isochronous pattern, and a 4 tap:1 beat isochronous pattern -, a reaction task to an aperiodic and unpredictable pattern, and a reproduction task of an isochronous pattern after passively listening.ResultsPWS were able to reproduce an isochronous pattern on their own, without external auditory stimuli, with similar accuracy as PNS, but with increased variability. This group difference in variability was observed immediately after passive listening, without prior motor engagement, and was not enhanced or reduced after several seconds of tapping. Although PWS showed increased tapping variability in the reproduction task as well as in synchronization tasks, this timing variability did not correlate significantly with the variability in reaction times or tapping force. Compared to PNS, PWS exhibited larger negative mean asynchronies, and increased synchronization variability in synchronization tasks. These group differences were not affected by beat hierarchy (i.e., "strong" vs. "weak" beats), pattern complexity (non-isochronous vs. isochronous) or presence versus absence of external auditory stimulus (1:1 vs. 1:4 isochronous pattern). Differences between PWS and PNS were not enhanced or reduced with sensorimotor learning, over the first taps of a synchronization task.ConclusionOur observations support the hypothesis of a deficit in neuronal oscillators coupling in production, but not in perception, of rhythmic patterns, and a larger delay in multi-modal feedback processing for PWS.

Project description:BackgroundThe prevalence and impact of motor coordination difficulties in children with copy number variants associated with neurodevelopmental disorders (ND-CNVs) remains unknown. This study aims to advance understanding of motor coordination difficulties in children with ND-CNVs and establish relationships between intelligence quotient (IQ) and psychopathology.Methods169 children with an ND-CNV (67% male, median age = 8.88 years, range 6.02-14.81) and 72 closest-in-age unaffected siblings (controls; 55% male, median age = 10.41 years, s.d. = 3.04, range 5.89-14.75) were assessed with the Developmental Coordination Disorder Questionnaire, alongside psychiatric interviews and standardised assessments of IQ.ResultsThe children with ND-CNVs had poorer coordination ability (b = 28.98, p < 0.001) and 91% of children with an ND-CNV screened positive for suspected developmental coordination disorder, compared to 19% of controls (OR = 42.53, p < 0.001). There was no difference in coordination ability between ND-CNV genotypes (F = 1.47, p = 0.184). Poorer coordination in children with ND-CNV was associated with more attention deficit hyperactivity disorder (ADHD) (β = -0.18, p = 0.021) and autism spectrum disorder trait (β = -0.46, p < 0.001) symptoms, along with lower full-scale (ß = 0.21, p = 0.011), performance (β = -0.20, p = 0.015) and verbal IQ (β = 0.17, p = 0.036). Mediation analysis indicated that coordination ability was a full mediator of anxiety symptoms (69% mediated, p = 0.012), and a partial mediator of ADHD (51%, p = 0.001) and autism spectrum disorder trait symptoms (66%, p < 0.001) as well as full scale IQ (40%, p = 0.002), performance IQ (40%, p = 0.005) and verbal IQ (38%, p = 0.006) scores.ConclusionsThe findings indicate that poor motor coordination is highly prevalent and closely linked to risk of mental health disorder and lower intellectual function in children with ND-CNVs. Future research should explore whether early interventions for poor coordination ability could ameliorate neurodevelopmental risk.

Project description:Background: The reliable assessment, attribution, and alleviation of upper-limb joint stiffness are essential clinical objectives in the early rehabilitation from stroke and other neurological disorders, to prevent the progression of neuromuscular pathology and enable proactive physiotherapy toward functional recovery. However, the current clinical evaluation and treatment of this stiffness (and underlying muscle spasticity) are severely limited by their dependence on subjective evaluation and manual limb mobilization, thus rendering the evaluation imprecise and the treatment insufficiently tailored to the specific pathologies and residual capabilities of individual patients. Methods: To address these needs, the proposed clinical trial will employ the NEUROExos Elbow Module (NEEM), an active robotic exoskeleton, for the passive mobilization and active training of elbow flexion and extension in 60 sub-acute and chronic stroke patients with motor impairments (hemiparesis and/or spasticity) of the right arm. The study protocol is a randomized controlled trial consisting of a 4-week functional rehabilitation program, with both clinical and robotically instrumented assessments to be conducted at baseline and post-treatment. The primary outcome measures will be a set of standard clinical scales for upper limb spasticity and motor function assessment, including the Modified Ashworth Scale and Fugl-Meyer Index, to confirm the safety and evaluate the efficacy of robotic rehabilitation in reducing elbow stiffness and improving function. Secondary outcomes will include biomechanical, muscular activity, and motor performance parameters extracted from instrumented assessments using the NEEM along with synchronous EMG recordings. Conclusions: This randomized controlled trial aims to validate an innovative instrumented methodology for clinical spasticity assessment and functional rehabilitation, relying on the precision and accuracy of an elbow exoskeleton combined with EMG recordings and the expertise of a physiotherapist, thus complementing and maximizing the benefits of both practices. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04484571.

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An Instrumented Assessment of a Rhythmic Finger Task among Children with Motor Coordination Difficulties.

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An Instrumented Assessment of a Rhythmic Finger Task among Children with Motor Coordination Difficulties.

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