Article

PURPOSE: To compare upper limb kinematics of children with spastic cerebral palsy
(CP) using a passive rehabilitation joystick with those of adults and able-bodied
children, to better understand the design requirements of computer-based
rehabilitation devices. METHOD: A blocked comparative study involving seven
children with spastic CP, nine able-bodied adults and nine able-bodied children,
using a joystick system to play a computer game whilst the kinematics of their
upper limb were recorded. The translational kinematics of the joystick's end
point and the participant's shoulder movement (protraction/retraction) and elbow
rotational kinematics (flexion/extension) were analysed for each group. RESULTS:
Children with spastic CP matched their able-bodied peers in the time taken to
complete the computer task, but this was due to a failure to adhere to the task
instructions of travelling along a prescribed straight line when moving between
targets. The spastic CP group took longer to initiate the first movement, which
showed jerkier trajectories and demonstrated qualitatively different movement
patterns when using the joystick, with shoulder movements that were significantly
of greater magnitude than the able-bodied participants. CONCLUSIONS: Children
with spastic CP generate large shoulder and hence trunk movements when using a
joystick to undertake computer-generated arm exercises. This finding has
implications for the development and use of assistive technologies to encourage
exercise and the instructions given to users of such systems. IMPLICATIONS FOR
REHABILITATION: A kinematic analysis of upper limb function of children with CP
when using joystick devices is presented. Children with CP may use upper body
movements to compensate for limitations in voluntary shoulder and elbow movements
when undertaking computer games designed to encourage the practice of arm
movement. The design of rehabilitative computer exercise systems should consider
movement of the torso/shoulder as it may have implications for the quality of
therapy in the rehabilitation of the upper limb in children with CP.

Langue : ANGLAIS