Robotic assessment of bilateral and unilateral upper limb functions in adults with cerebral palsy.
I Poitras, S P Dukelow, A Campeau-Lecours and 1 others
PMID 39169408WHAT IT FOUND
Adults with mild to moderate cerebral palsy were most often impaired on a robotic bilateral asymmetric hitting task, even when their everyday object handling was rated as mild.
Symmetric and unilateral reaching tasks identified fewer impairments.
Key findings
01On the bilateral asymmetric Object Hit task, 15 participants (78.9%) were impaired on the overall Task score, and this task identified the largest number of impaired participants.
02The unilateral reaching task identified impairment in 12 participants (63.1%) on the more affected arm and 6 participants (31.6%) on the less affected arm, and all less affected arm impairments were also present on the more affected arm.
03Feedforward control showed a very strong association between the more affected and less affected arms, while feedback control of the more affected arm was the unilateral category most often associated with bilateral task performance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was small, with 19 adults, and the authors state that adults with cerebral palsy are heterogeneous, so the impairment pattern may not apply to all adults with cerebral palsy. The participants were only at MACS levels I to III, so the results should not be extrapolated to MACS levels IV and V. The correlation objectives were exploratory, and many correlations in the text used uncorrected p-values, so some associations may be chance findings. The robotic tasks were not fully representative of real life because the arms were supported against gravity and movements were two-dimensional. The study did not have brain scans for the participants, so it could not group results by lesion site.
Declared interests
Funding was provided by the Canadian Institutes of Health Research, Research Scholar awards from FRQ-S, Fonds de Recherche du Québec - Santé, and an Université Laval Research Chair in Cerebral Palsy. The supplied text does not include an author competing-interest declaration.
The easy way to misread this
Do not read the high impairment rate as evidence that a robotic intervention improves upper limb function in cerebral palsy. This paper describes assessment results in a small group of adults with cerebral palsy and cannot separate motor planning, visual attention, and task difficulty.