title: Quantifying selective elbow movements during an exergame in children with neurological disorders: a pilot study.
abstract: BACKGROUND
  It is difficult to distinguish between restorative and compensatory mechanisms underlying (pediatric) neurorehabilitation, as objective measures assessing selective voluntary motor control (SVMC) are scarce.
  
  
  METHODS
  We aimed to quantify SVMC of elbow movements in children with brain lesions. Children played an airplane game with the glove-based YouGrabber system. Participants were instructed to steer an airplane on a screen through a cloud-free path by correctly applying bilateral elbow flexion and extension movements. Game performance measures were (i) % time on the correct path and (ii) similarity between the ideal flight path and the actually flown path. SVMC was quantified by calculating a correlation coefficient between the derivative of the ideal path and elbow movements. A therapist scored whether the child had used compensatory movements.
  
  
  RESULTS
  Thirty-three children with brain lesions (11 girls; 12.6 ± 3.6 years) participated. Clinical motor and cognitive scores correlated moderately with SVMC (0.50-0.74). Receiver Operating Characteristics analyses showed that SVMC could differentiate well and better than clinical and game performance measures between compensatory and physiological movements.
  
  
  CONCLUSIONS
  We conclude that a simple measure assessed while playing a game appears promising in quantifying SVMC. We propose how to improve the methodology, and how this approach can be easily extended to other joints.
authors: Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland. hubertus.vanhedel@kispi.uzh.ch.|Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland. hubertus.vanhedel@kispi.uzh.ch.
authors: Hubertus J A
authors: HJ
authors: van Hedel
authors: Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.|Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.|Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
authors: Nadine
authors: N
authors: Häfliger
authors: Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.|Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.|Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
authors: Corinna N
authors: CN
authors: Gerber
mesh_terms: D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000503:physiopathology; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology*; D010865:Pilot Projects; D016059:Range of Motion, Articular
keywords: Cerebral palsy; Compensation; Exergame; Psychometrics; Recovery; Rehabilitation; Validity; Volitional motor control