Differentiating Motor Coordination in Children with Cerebral Palsy and Typically Developing Populations Through Exploratory Factor Analysis of Robotic Assessments

General motor and executive functions are integral for tasks of daily living and are typically assessed when quantifying impairment of an individual. Robotic tasks offer highly repeatable and objective measures of motor and cognitive function. Additionally, robotic tasks and measures have been used successfully to quantify impairment of children with cerebral palsy (CP). Many robotic tasks include multiple performance parameters, so interpretation of results and identification of impairment can be difficult, especially when multiple tasks are completed. This study used exploratory factor analysis to investigate a potential set of quantitative models of motor and cognitive function in children, and compare performance of participants with CP to these models. The three calculated factors achieved strong differentiation between participants with mild CP and the typically developing population. This demonstrates the feasibility of these factors to quantify impairment and track improvements related to therapies.Clinical Relevance- This establishes a method to differentiate atypical motor performance related to CP using a robotic reversed visually guided reaching task.

Tools and Techniques Used With Robotic Devices to Quantify Upper-Limb Function in Typically Developing Children: A Systematic Review

Background:

Robotic devices have been used to quantify function, identify impairment, and rehabilitate motor function extensively in adults, but less-so in younger populations. The ability to perform motor actions improves as children grow. It is important to quantify this rate of change of the neurotypical population before attempting to identify impairment and target rehabilitation techniques.

Objectives:

For a population of typically developing children, this systematic review identifies and analyzes tools and techniques used with robotic devices to quantify upper-limb motor function. Since most of the papers also used robotic devices to compare function of neurotypical to pathological populations, a secondary objective was introduced to relate clinical outcome measures to identified robotic tools and techniques.

Methods:

Five databases were searched between February 2019 and August 2020, and 226 articles were found, 19 of which are included in the review.

Results:

Robotic devices, tasks, outcome measures, and clinical assessments were not consistent among studies from different settings but were consistent within laboratory groups. Fifteen of the 19 articles evaluated both typically developing and pathological populations.

Conclusion:

To optimize universally comparable outcomes in future work, it is recommended that a standard set of tasks and measures is used to assess upper-limb motor function. Standardized tasks and measures will facilitate effective rehabilitation.

Differentiating Motor Coordination and Position Sense in Children with Cerebral Palsy and Typically Developing Populations Through Robotic Assessments

Motor function and coordination improve as children age. Robotic assessments of motor function and coordination have been shown to be repeatable, objective, and accurate. Additionally, robotic assessments have been used to measure and quantify deficits in motor function and coordination in children with cerebral palsy (CP). Normative models of motor function and coordination based on age have not been used widely to differentiate impaired performance from typical performance. This study presents preliminary results of identifying deficits in motor function and coordination assessed with a robotic reaching task and using a normative model of typical performance that accounts for age, sex, and handedness. The models were compared with data from three participants with CP to evaluate whether the models could be used to identify deficits in motor function. The models indicated motor deficits in one participant when performing a visually guided reaching task with respect to initial speed and distance ratios. There was no evidence of motor control deficits in the other two participants. Future work will refine the models to be able to better identify and quantify motor control impairments with the potential to target therapy around quantifiable goals.