Article

Patients with hemiplegic cerebral palsy often have noticeably deviant arm posture
and decreased arm movement. Here we develop a comprehensive assessment method for
the upper extremity during walking. Arm posture score (APS), deviation of
shoulder flexion/extension, shoulder abduction/adduction, elbow flexion/extension
and wrist flexion/extension were calculated from three-dimensional gait analysis.
The APS is the root mean square deviation from normal, similar to Baker's Gait
Profile Score (GPS) [1]. The total range of motion (ROM) was defined as the
difference between the maximum and minimum position in the gait cycle for each
variable. The arm symmetry, arm posture index (API) was calculated by dividing
the APS on the hemiplegic side by that on the non-involved side, and the range of
motion index (ROMI) by dividing the ROM on the hemiplegic side by that on the
non-involved side. Using the APS, two groups were defined. Group 1 had minor
deviations, with an APS under 9.0 and a mean of 6.0 (95% CI 5.0-7.0). Group 2 had
more pronounced deviations, with an APS over 9.0 and a mean of 13.1 (CI 10.8-15.5) (p=0.000). Total ROM was 60.6 in group 1 and 46.2 in group 2
(p=0.031). API was 0.89 in group 1 and 1.70 in group 2 (p<0.001). ROMI was 1.15
in group 1 and 0.69 in group 2 (p=0.003). APS describes the amount of deviation,
ROM provides additional information on movement pattern and the indices the
symmetry. These comprehensive objective and dynamic measurements of upper
extremity abnormality can be useful in following natural progression, evaluating
treatment and making prognoses in several categories of patients.
CI - Copyright (c) 2010 Elsevier B.V. All rights reserved.

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