title: Wearable wrist activity monitor as an indicator of functional hand use in children with cerebral palsy.
abstract: OBJECTIVE
  New tools that capture hand function in everyday activities and contexts are needed for assessing children with hemiplegic cerebral palsy. This study evaluates a wearable wrist monitor and tests the hypothesis that wrist extension frequency (FreqE) is an appropriate indicator of functional hand use.
  
  
  METHODS
  Fifteen children (four females, 11 males; age range 6-12y; mean age 10y [SD 2y]) with hemiplegia (seven at level I and eight at level II on the Manual Ability Classification System) participated in the Assisting Hand Assessment (AHA) while wearing the wrist monitor. FreqEs were captured via the wrist monitor and validated using video analysis. Correlations between FreqE and AHA scores were calculated and a multivariate linear regression was conducted to explore other measures of wrist activity.
  
  
  RESULTS
  Wrist extensions observed in video analyses were reliably detected by the wrist monitor (intraclass correlation coefficient, r=0.88; p<0.001) and were strongly correlated with the AHA scores (r=0.93; p<0.001). AHA scores were significantly correlated with FreqE (r=0.80; p=0.001) and the range of wrist extensions/flexions (r=0.70; p=0.008). The multivariate linear regression combining the FreqE and range of wrist extensions/flexions yielded a strong correlation with AHA scores (r=0.84; p=0.0043).
  
  
  CONCLUSIONS
  The wearable wrist monitor may offer a convenient, valid alternative to observer reports for functional assessments of the hemiplegic hand in everyday contexts.
authors: Institute of Biomaterial & Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
authors: Jennifer
authors: J
authors: Howcroft
authors: Darcy
authors: D
authors: Fehlings
authors: Karl
authors: K
authors: Zabjek
authors: Linda
authors: L
authors: Fay
authors: Jack
authors: J
authors: Liang
authors: Elaine
authors: E
authors: Biddiss
mesh_terms: D002547:Cerebral Palsy / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D009048:Motor Skills / Q000502:physiology*; D012044:Regression Analysis; D015203:Reproducibility of Results; D014741:Video Recording; D014953:Wrist / Q000294:innervation / Q000503:physiopathology*