Assessment of Proprioception Impairments in Children with ...Assessment of Proprioception...
1
Assessment of Proprioception Impairments in Children with Unilateral Spastic Cerebral Palsy Using a Markerless Motion Capture System David Putrino, PT, PhD 1,2 Karen Chin, MA 1,2 Behdad Dehbandi, PhD 1,2 Victor Nwankwo, MD 1,2 Andrew Gordon, PhD 3 Kathleen Friel, PhD 1,2,4 1 Burke Medical Research Institute, White Plains, NY 2 Weill Cornell Medical College, New York, NY 3 Teachers College Columbia University, New York, NY 4 Blythedale Children’s Hospital, Valhalla, NY BACKGROUND / OBJECTIVE d • Proprioception is the ability to sense the position of a limb in space without visual feedback. It is an important contributor to motor control. d • Neurological impairment oſten causes proprioception deficits, which can impede one’s ability to perform motor skills accurately. d • Currently, there are no reliable quantitative scales that can measure proprioception accurately and affordably. d • We developed a low-cost assessment tool using the Microsoſt Kinect 2 to non-invasively and easily quantify proprioception in children with unilateral spastic cerebral palsy (USCP). d METHODS D • 29 children with USCP (6.1-19y), 13 females 6 typically-developing controls (9.2-17.9y), 6 females d1 • Participants were seated 1m in front of the Kinect. d • ey had to perform 3 different tasks while blindfolded, and hold each position for 3 seconds: • • 3 centroids of interest were the elbow, shoulder, and wrist. s • e model arm was always placed in position by the experimenter. RESULTS D D • d DISCUSSION / CONCLUSIONS • d • Proprioception is an important component of motor control, but has been difficult in the past to quantify. D • We focused our analysis only on the contralateral matching task because factors such as attention and memory may have confounded results of the other two tasks. In the future, we plan to administer psychosocial measures to account for such factors. • Correlational analysis showed significant associations between y- and z- coordinate displacement and widely-used clinical measures. More advanced analyses are needed to examine these further. METHODS (cont’d) • e Kinect captured the xyz coordinates of each of the child’s upper body joints. D • • Matlab was used to process the data and quantify differences in joint positions between the model and test arms. Ds • Other measures collected: 1: Ipsilateral Remembered 2: Contralateral Remembered 3: Contralateral Matching Model Arm Test Arm Hand Function and Dexterity • Manual Ability Classification System (MACS) • Jebsen-Taylor Test of Hand Function (JTTHF) • Box and Blocks (BB) Somatosensory • Cooper-Stereognosis (CS) Questions/Comments? Email Karen Chin at [email protected] ✉ Time (frames) z-coord distance from centroid y-coord distance from centroid Time (frames) x-coord distance from centroid Time (frames) y-coordinate displacement z-coordinate displacement y-coordinate displacement z-coordinate displacement Spearman rho 0.48 0.4 0.58 0.4 Sig. (2-tailed) 0.028 0.08 0.005 0.06 Spearman rho 0.48 N.S. 0.46 N.S. Sig. (2-tailed) 0.026 N.S. 0.03 N.S. Spearman rho 0.81 N.S. N.S. N.S. Sig. (2-tailed) 0.0085 N.S. N.S. N.S. Spearman rho 0.74 0.62 0.67 0.61 Sig. (2-tailed) 0.00027 0.005 0.0016 0.0057 Spearman rho N.S. N.S. 0.49 N.S. Sig. (2-tailed) N.S. N.S. 0.02 N.S. N.S. = not significant JTTHF MACS Affected Elbow Affected Shoulder Contralateral Matching Task - Significant Correlations Cooper-Stereognosis Box and Blocks AHA • We found significant differences between CP and controls for y- and z-coordinate displacement scores for elbow and shoulder centroids in the contralateral matching task (p < .001). 0 1 2 3 4 5 6 7 8 Mean Y displacement Mean Z displacement Mean Y displacement Mean Z displacement Elbow Shoulder Control CP Distance from centroid
Transcript of Assessment of Proprioception Impairments in Children with ...Assessment of Proprioception...
Assessment of Proprioception Impairments in Children with Unilateral Spastic Cerebral Palsy Using a Markerless Motion Capture System
David Putrino, PT, PhD1,2 Karen Chin, MA1,2 Behdad Dehbandi, PhD1,2 Victor Nwankwo, MD1,2 Andrew Gordon, PhD3 Kathleen Friel, PhD1,2,4 1 Burke Medical Research Institute, White Plains, NY 2 Weill Cornell Medical College, New York, NY
3 Teachers College Columbia University, New York, NY 4 Blythedale Children’s Hospital, Valhalla, NY
BACKGROUND / OBJECTIVE d
• Proprioception is the ability to sense the position of a limb in space without visual feedback. It is an important contributor to motor control. d
• Neurological impairment often causes proprioception deficits, which can impede one’s ability to perform motor skills accurately. d
• Currently, there are no reliable quantitative scales that can measure proprioception accurately and affordably. d
• We developed a low-cost assessment tool using the Microsoft Kinect 2 to non-invasively and easily quantify proprioception in children with unilateral spastic cerebral palsy (USCP). d
METHODS D
• 29 children with USCP (6.1-19y), 13 females 6 typically-developing controls (9.2-17.9y), 6 females d1
• Participants were seated 1m in front of the Kinect. d
• They had to perform 3 different tasks while blindfolded, and hold each position for 3 seconds:
•
• 3 centroids of interest were the elbow, shoulder, and wrist. s
• The model arm was always placed in position by the experimenter.
RESULTS D
D
• d
DISCUSSION / CONCLUSIONS • d
• Proprioception is an important component of motor control, but has been difficult in the past to quantify. D
• We focused our analysis only on the contralateral matching task because factors such as attention and memory may have confounded results of the other two tasks. In the future, we plan to administer psychosocial measures to account for such factors.
• Correlational analysis showed significant associations between y- and z- coordinate displacement and widely-used clinical measures. More advanced analyses are needed to examine these further.
METHODS (cont’d) • The Kinect captured the xyz
coordinates of each of the child’s upper body joints. D
•
• Matlab was used to process the data and quantify differences in joint positions between the model and test arms. Ds
• Other measures collected: D
1: Ipsilateral Remembered
2: Contralateral Remembered
3: Contralateral Matching
Model
Arm
Test Arm
Hand Function
and Dexterity
• Manual Ability Classification System (MACS) • Jebsen-Taylor Test of Hand Function (JTTHF) • Box and Blocks (BB)
Somatosensory • Cooper-Stereognosis (CS) Questions/Comments? Email Karen Chin at [email protected] ✉
Time (frames)
z-co
ord
dist
ance
fr
om ce
ntro
id y-
coor
d di
stan
ce
from
cent
roid
Time (frames)
x-co
ord
dist
ance
fr
om ce
ntro
id
Time (frames)
y-coordinatedisplacement
z-coordinatedisplacement
y-coordinatedisplacement
z-coordinatedisplacement
Spearmanrho 0.48 0.4 0.58 0.4Sig.(2-tailed) 0.028 0.08 0.005 0.06Spearmanrho 0.48 N.S. 0.46 N.S.Sig.(2-tailed) 0.026 N.S. 0.03 N.S.Spearmanrho 0.81 N.S. N.S. N.S.Sig.(2-tailed) 0.0085 N.S. N.S. N.S.Spearmanrho 0.74 0.62 0.67 0.61Sig.(2-tailed) 0.00027 0.005 0.0016 0.0057Spearmanrho N.S. N.S. 0.49 N.S.Sig.(2-tailed) N.S. N.S. 0.02 N.S.
N.S.=notsignificant
JTTHF
MACS
AffectedElbowAffectedShoulder
ContralateralMatchingTask-SignificantCorrelations
Cooper-Stereognosis
BoxandBlocks
AHA
• We found significant differences between CP and controls for y- and z-coordinate displacement scores for elbow and shouldercentroids in the contralateral matchingtask (p < .001).
0
1
2
3
4
5
6
7
8
Mean Y displacement
Mean Z displacement
Mean Y displacement
Mean Z displacement
Elbow Shoulder
Control
CP
Dist
ance
from
cent
roid
