Wearable wrist activity monitor as an indicator of functional hand use in children with cerebral palsy


  • This article is commented on by Bialocerkowski on page 976 of this issue.

Dr Elaine Biddiss at Bloorview Research Institute, 150 Kilgour Road, Toronto, ON, Canada M4G 1R8. E-mail: elaine.biddiss@utoronto.ca


Aim  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.

Method  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).

Interpretation  The wearable wrist monitor may offer a convenient, valid alternative to observer reports for functional assessments of the hemiplegic hand in everyday contexts.