Game-based Mobile-Health Quantification of Upper-Limb Motor Performance in Children with Hemiparetic Cerebral Palsy

PROJECT SUMMARY The main goal of this research project is to test and validate a mobile health (mHealth) application to quantify upper limb motor performance in children with hemiparetic cerebral palsy (HCP). Movement impairments

impact activities of daily living and performance of functional activities, thus limiting children’s participation and quality of life. Rigorous and quantifiable assessments provide key data for treatment planning and offer insight into the pathophysiology of motor impairments. Clinical assessments of the upper-limb can be subjective,

require in-person visits with trained personnel, and specialized equipment. Alternatively, laboratory assessments are quantifiable and precise but also require in-person visits with specialized equipment. Existing mobile technology, such as the iPad tablet, offers the potential for objective and quantifiable measurement in

any environment. As a first step in this research, we will test the reliability, validity, and usability of a mobile health (mHealth) application to measure upper limb movement performance in a controlled-laboratory setting. Our team has developed an mHealth application for the iPad featuring interactive games to quantify upper-limb

movement performance. Children with HCP and typically-developing age-matched children will participate in the study consisting of two in-person visits to a laboratory. During each session, they will play five mHealth movement games requiring visually-guided multi-joint movements, fine motor and finger control, and bimanual

coordination. In Aim 1, we will determine the reliability, validity, and usability of the mHealth application. Test- retest reliability and concurrent validity with 3D optical motion capture will be evaluated; usability will be evaluated with a standardized mHealth questionnaire. In Aim 2, we will further examine the validity of the

mHealth application by comparing motor performance outcomes with other standardized assessments and questionnaires of the upper-limb that span multiple ICF domains (body function, activity, and participation). If successful, mobile technology may be implemented in a follow-up cohort study to study longitudinal upper-limb

motor development, recovery, and response to neurorehabilitation interventions in children with HCP. More broadly, the outcomes of this research will impact how and where motor evaluations can be performed, offering a flexible methodology for researchers performing longitudinal and telerehabilitation studies. Importantly,

mobile technology offers an option for remote participation that may significantly expand the participant pool, allowing for more diverse and representative samples in future work.