Detecting Asymmetry of Upper Limb Activity with Accelerometry in Infants at Risk for Unilateral Spastic Cerebral Palsy

AimsTo examine whether accelerometry can quantitate asymmetry of upper limb activity in infants aged 3-12 months at risk for developing unilateral spastic cerebral palsy (USCP).MethodA prospective study was performed in 50 infants with unilateral perinatal brain injury at high risk of developing USCP. Triaxial accelerometers were worn on the ipsilateral and contralesional upper limb during the Hand Assessment for Infants (HAI). Infants were grouped in three age intervals (3-5 months, 5-7.5 months and 7.5 until 12 months). Each age interval group was divided in a group with and without asymmetrical hand function based on HAI cutoff values suggestive of USCP.ResultsIn a total of 82 assessments, the asymmetry index for mean upper limb activity was higher in infants with asymmetrical hand function compared to infants with symmetrical hand function in all three age groups (ranging from 41 to 51% versus - 2-6%, p < 0.01), while the total activity of both upper limbs did not differ.ConclusionsUpper limb accelerometry can identify asymmetrical hand function in the upper limbs in infants with unilateral perinatal brain injury from 3 months onwards and is complementary to the Hand Assessment for Infants.

Automated summary

This study aims to examine whether accelerometry can quantify the asymmetry of upper limb activity in infants at risk for developing unilateral spastic cerebral palsy. A prospective study was conducted on 50 infants with unilateral perinatal brain injury. The results showed that infants with asymmetrical hand function had a higher asymmetry index for mean upper limb activity compared to infants with symmetrical hand function in all age groups, while the total activity of both upper limbs did not differ. It was concluded that upper limb accelerometry can identify asymmetrical hand function in infants with unilateral perinatal brain injury from 3 months onwards and complement the Hand Assessment for Infants.