Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Individuals
2.2. Cervical Motor Control Test Development and Application
2.3. Funcional Assessment
2.4. Statistical Analysis
2.4.1. Validity Analysis
2.4.2. Reliability Analysis
3. Results
3.1. Construct Validity
3.2. Concurrent Validity
3.3. Test–Retest Reliability
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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CP Group (n = 24) | Control Group (n = 24) | p-Value | |
---|---|---|---|
Age (years) | 9.1 (3.0) | 8.8 (3.2) | 0.720 |
Sex (women/men) | 15/9 | 15/9 | |
Weight (kg) | 28.5 (12.9) | 33.2 (14.0) | 0.250 |
Height (m) | 1.33 (0.22) | 1.35 (0.23) | 0.736 |
BMI (Z-score) | −0.15 (1.19) | 0.08 (1.30) | 0.171 |
GMFCS level (frequency) | I: 11; II: 4; III: 1; IV: 8 | - | - |
Type of motor disorder (frequency) | Spastic: 20; Dyskinetic: 3; Ataxic: 0; Mixed: 1 | - | - |
GMFM-88 | - | - | |
Dimension A | 81.7 (24.3) | - | - |
Dimension B | 73.5 (32.9) | ||
Dimension C | 62.8 (39.4) | ||
Dimension D | 54.2 (39.4) | ||
Dimension E | 46.1 (38.3) | - | - |
Total score | 63.6 (33.7) | - | - |
PEDI | - | - | |
Self-Care | 24.1 (13.52) | - | - |
Mobility | 20.1 (12.8) | - | - |
Social Function | 18.8 (7.3) | - | - |
Total Score | 63.0 (32.1) | - | - |
CP Group (n = 24) | Control Group (n = 24) | Mean Difference (95% CI) | p-Value | |
---|---|---|---|---|
Movement characteristics | ||||
Flexion-extension angle (°) | 8.59 (8.69) | 3.93 (2.88) | −4.66 (−8.56; −0.75) | 0.021 |
Rotational angle (°) | 10.29 (11.30) | 2.57 (2.53) | −7.72 (−12.70; −2.75) | 0.004 |
Lateral angle (°) | 7.16 (6.01) | 2.59 (2.36) | −4.57 (−7.32; −1.83) | 0.002 |
Mean angle (°) | 8.68 (7.78) | 3.03 (2.20) | −5.65 (−9.11; −2.19) | 0.002 |
Flexion-extension velocity (°/s) | 8.77 (9.92) | 4.85 (3.97) | −3.92 (−8.45; 0.61) | 0.087 |
Rotational velocity (°/s) | 10.35 (14.64) | 4.24 (5.75) | −6.11 (−12.79; 0.57) | 0.071 |
Lateral velocity (°/s) | 8.22 (9.25) | 4.72 (4.22) | −3.49 (−7.79; 0.81) | 0.107 |
Mean velocity (°/s) | 9.11 (11.13) | 4.61 (4.56) | −4.51 (−9.61; 0.59) | 0.081 |
Flexion-extension acceleration (°/s2) | 128.75 (157.13) | 107.92 (75.53) | −20.82 (−94.40; 52.75) | 0.568 |
Rotational acceleration (°/s2) | 128.54 (175.01) | 91.48 (62.83) | −37.06 (−116.23; 42.11) | 0.345 |
Lateral acceleration (°/s2) | 142.52 (159.44) | 121.98 (92.79) | −20.53 (−97.85; 56.78) | 0.593 |
Mean acceleration (°/s2) | 133.27 (162.05) | 107.13 (75.02) | −26.14 (−101.60; 49.32) | 0.485 |
Ellipse variables | ||||
Distance (°/s) | 11.61 (13.75) | 6.43 (4.86) | −5.18 (−11.39; 1.04) | 0.099 |
Area (°2) | 857.18 (1374.52) | 91.33 (206.35) | −765.85 (−1364.98; −166.72) | 0.015 |
Angle (°) | 7.01 (27.01) | 0.64 (21.80) | −6.38 (−20.59; 7.83) | 0.371 |
A-dimension (°) | 12.34 (12.24) | 4.59 (3.32) | −7.75 (−13.18; −2.31) | 0.007 |
B-dimension (°) | 13.25 (13.96) | 3.65 (5.11) | −9.60 (−15.92; −3.27) | 0.004 |
Dimension A | Dimension B | Dimension C | Dimension D | Dimension E | GMFM-88 Total Score | Self-Care | Mobility | Social Function | PEDI Total Score | |
---|---|---|---|---|---|---|---|---|---|---|
Age | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. |
Weight | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. |
Height | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. |
BMI | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | 0.414; 0.048 | n.s. | 0.596; 0.003 | 0.442; 0.035 |
Flexion-extension angle | −0.738; <0.001 | −0.677; <0.001 | −0.615; 0.002 | −0.589; 0.003 | −0.626; 0.001 | −0.663; 0.001 | −0.723; <0.001 | −0.702; <0.001 | −0.590; 0.003 | −0.715; <0.001 |
Rotational angle | −0.446; 0.033 | n.s. | n.s. | n.s. | −0.432; 0.040 | n.s. | −0.575; 0.004 | −0.472; 0.023 | −0.583; 0.004 | −0.561; 0.005 |
Lateral angle | n.s. | n.s. | n.s. | n.s. | −0.465.026 | n.s. | −0.476; 0.022 | −0.419; 0.046 | −0.463; 0.026 | −0.472; 0.026 |
Mean angle | −0.569; 0.005 | −0.523; 0.010 | −0.478; 0.021 | −0.451; 0.031 | −0.562; 0.005 | −0.530; 0.009 | −0.670; <0.001 | −0.597; 0.003 | −0.622; 0.002 | −0.660; 0.001 |
Flexion-extension velocity | −0.516; 0.012 | −0.447; 0.032 | −0.415; 0.049 | −0.348 | −0.434; 0.034 | −0.439; 0.036 | −0.574; 0.004 | −0.479; 0.021 | −0.516; 0.012 | −0.549; 0.007 |
Rotational velocity | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | −0.500 | n.s. | −0.490 | n.s. |
Lateral velocity | −0.557; 0.006 | −0.508; 0.013 | −0.467; 0.025 | −0.415; 0.049 | −0.480; 0.020 | −0.495; 0.016 | −0.621; 0.002 | −0.535; 0.009 | −0.573; 0.004 | −0.604; 0.002 |
Mean velocity | −0.472; 0.023 | −0.414; 0.048 | n.s. | n.s. | −0.428; 0.041 | −0.416; 0.048 | −0.562; 0.005 | −0.462; 0.026 | −0.527; 0.010 | −0.539; 0.008 |
Flexion-extension acceleration | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | −0.427; 0.042 | n.s. | n.s. | n.s. |
Rotational acceleration | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | −0.442; 0.035 | n.s. | n.s. | −0.417; 0.046 |
Lateral acceleration | −0.521; 0.011 | −0.472; 0.023 | −0.426; 0.042 | n.s. | n.s. | −0.443; 0.034 | −0.573; 0.004 | −0.477; 0.021 | −0.542; 0.008 | −0.553; 0.006 |
Mean acceleration | −0.432; 0.039 | n.s. | n.s. | n.s. | n.s. | n.s. | −0.485; 0.019 | n.s. | −0.443; 0.034 | −0.459; 0.028 |
Distance | −0.481; 0.020 | −0.423; 0.044 | n.s. | n.s. | −0.424; 0.044 | −0.418; 0.047 | −0.560; 0.005 | −0.462; 0.026 | −0.526; 0.010 | −0.538; 0.008 |
Area | −0.578; 0.004 | −0.504; 0.014 | −0.461; 0.027 | n.s. | −0.477; 0.021 | −0.489; 0.018 | −0.640; 0.001 | −0.545; 0.007 | −0.606; 0.002 | −0.623; 0.001 |
Angle | −0.417; 0.048 | −0.478; 0.021 | −0.429; 0.041 | −0.453; 0.030 | −0.439; 0.036 | −0.460; 0.027 | −0.470; 0.024 | −0.495; 0.016 | −0.516; 0.016 | −0.511; 0.016 |
A-dimension | −0.711; <0.001 | −0.649; 0.001 | −0.595; 0.003 | −0.568; 0.005 | −0.639; 0.001 | −0.647; 0.001 | −0.754; <0.001 | −0.703; <0.001 | −0.700; <0.001 | −0.748; <0.001 |
B-dimension | n.s. | n.s. | n.s. | n.s. | n.s. | n.s. | −0.540; 0.008 | −0.423; 0.044 | −0.575; 0.004 | −0.525; 0.010 |
Predictor Variables | B | Standard Error B | 95% CI | Β | t | p | R2 Adjusted | |
---|---|---|---|---|---|---|---|---|
GMGM-88 total score | Step 1 Flexion-extension angle | −2.569 | 0.633 | −3.885, −1.254 | −0.663 | −4.062 | 0.001 | 0.413 |
Step 2 | 0.548 | |||||||
Flexion-extension angle | −2.734 | 0.587 | −3.959, −1.508 | −0.706 | −4.653 | <0.001 | ||
Age | −3.428 | 1.573 | −6.708, −0.147 | −0.331 | −2.180 | 0.041 | ||
Step 3 | 0.638 | |||||||
Flexion-extension angle | −2.607 | 0.542 | −3.741, −1.472 | −0.673 | −4.809 | <0.001 | ||
Age | −8.634 | 2.791 | −14.485, −2.800 | −0.833 | −3.096 | 0.006 | ||
Height | 100.671 | 46.130 | 4.121, 197.222 | 0.591 | 2.182 | 0.042 | ||
PEDI total score | Step 1 | 0.560 | ||||||
Area | −1.963 | 0.380 | −2.753, −1.173 | −0.748 | −5.170 | <0.001 | ||
Step 2 | 0.653 | |||||||
Area | −3.037 | 0.577 | −4.242, −1.833 | −1.158 | −5.261 | <0.001 | ||
Rotational acceleration | 0.094 | 0.040 | 0.010, 0.178 | 0.511 | 2.322 | 0.031 | ||
Step 3 | 0.790 | |||||||
Area | −2.747 | 0.508 | −3.814, −1.681 | −1.047 | −5.412 | <0.001 | ||
Rotational acceleration | 0.255 | 0.068 | 0.111, 0.398 | 1.387 | 3.721 | 0.002 | ||
Age | −2.265 | 1.078 | −4.530, –0.001 | −0.229 | −2.102 | 0.050 | ||
Step 4 | 0.833 | |||||||
Area | −2.486 | 0.484 | −3.502, −1.470 | −0.947 | −5.139 | <0.001 | ||
Rotational acceleration | 0.357 | 0.082 | 0.186, 0.529 | 1.946 | 4.373 | <0.001 | ||
Age | −3.012 | 0.967 | −5.043, −0.981 | −0.304 | −3.116 | 0.006 | ||
Distance | −3.837 | 1.158 | −6.270, −1.405 | −1.643 | −3.314 | 0.004 |
Intra-Day Reliability | |||||
---|---|---|---|---|---|
Spatial Plane | Second Day Data (Standard Deviation) | ICC (95% CI) | SEM | MDC90 | |
CP group (n = 24) | |||||
Flexion-extension angle (°) | 8.29 (6.30) | 0.826 (0.579, 0.928) | 3.13 | 7.25 | |
Rotational angle (°) | 8.50 (8.48) | 0.918 (0.804, 0.966) | 2.83 | 6.57 | |
Lateral angle (°) | 6.67 (6.16) | 0.821 (0.566, 0.926) | 2.58 | 5.97 | |
Mean angle (°) | 7.82 (6.22) | 0.923 (0.817, 0.968) | 1.94 | 4.51 | |
Flexion-extension velocity (°/s) | 9.81 (9.00) | 0.921 (0.812, 0.967) | 2.66 | 6.16 | |
Rotational velocity (°/s) | 11.71 (13.03) | 0.916 (0.799, 0.965) | 4.00 | 9.30 | |
Lateral velocity (°/s) | 8.67 (8.21) | 0.889 (0.731, 0.954) | 2.91 | 6.75 | |
Mean velocity (°/s) | 10.06 (9.88) | 0.919 (0.805, 0.966) | 2.99 | 6.93 | |
Flexion-extension acceleration (°/s2) | 146.09 (153.44) | 0.914 (0.795, 0.964) | 45.54 | 105.61 | |
Rotational acceleration (°/s2) | 138.06 (138.83) | 0.882 (0.714, 0.951) | 54.91 | 125.02 | |
Lateral acceleration (°/s2) | 141.31 (127.34) | 0.854 (0.645, 0.939) | 54.79 | 127.07 | |
Mean acceleration (°/s2) | 141.82 (137.58) | 0.892 (0.739, 0.955) | 49.23 | 114.19 | |
Distance (°/s) | 11.83 (11.20) | 0.929 (0.829, 0.971) | 3.32 | 7.71 | |
Area (°2) | 944.56 (1599.32) | 0.901 (0.761, 0.959) | 467.85 | 1085.09 | |
Angle (°) | −2.48 (22.44) | 0.595 (0.334, 0.618) | 15.74 | 36.50 | |
A-dimension (°) | 13.11 (10.67) | 0.770 (0.439, 0.905) | 5.49 | 12.74 | |
B-dimension (°) | 14.35 (16.72) | 0.941 (0.860, 0.976) | 3.73 | 8.64 | |
Control group (n = 24) | |||||
Flexion-extension angle (°) | 4.45 (4.49) | 0.652 (0.388, 0.850) | 2.18 | 5.04 | |
Rotational angle (°) | 2.45 (2.38) | 0.894 (0.757, 0.954) | 0.80 | 1.86 | |
Lateral angle (°) | 2.08 (1.64) | 0.774 (0.486, 0.901) | 0.95 | 2.21 | |
Mean angle (°) | 2.99 (2.43) | 0.934 (0.849, 0.972) | 0.59 | 1.38 | |
Flexion-extension velocity (°/s) | 4.13 (2.23) | 0.704 (0.332, 0.870) | 1.69 | 3.91 | |
Rotational velocity (°/s) | 3.22 (3.48) | 0.839 (0.631, 0.930) | 1.85 | 4.29 | |
Lateral velocity (°/s) | 4.02 (2.37) | 0.656 (0.321, 0.850) | 1.93 | 4.48 | |
Mean velocity (°/s) | 3.79 (2.49) | 0.751 (0.437, 0.891) | 1.76 | 4.08 | |
Flexion-extension acceleration (°/s2) | 98.09 (60.10) | 0.637 (0.365, 0.843) | 40.86 | 94.76 | |
Rotational acceleration (°/s2) | 77.84 (55.80) | 0.578 (0.048, 0.816) | 38.53 | 89.37 | |
Lateral acceleration (°/s2) | 105.27 (62.22) | 0.495 (0.000, 0.780) | 54.08 | 127.74 | |
Mean acceleration (°/s2) | 93.74 (56.87) | 0.587 (0.263, 0.820) | 42.38 | 98.29 | |
Distance (°/s) | 5.45 (2.86) | 0.522 (0.000, 0.791)) | 2.67 | 6.19 | |
Area (°2) | 82.59 (214.80) | 0.927 (0.831, 0.968) | 56.89 | 131.96 | |
Angle (°) | 3.02 (20.41) | 0.514 (0.000, 0.792) | 14.71 | 34.13 | |
A-dimension (°) | 4.98 (3.58) | 0.944 (0.871, 0.976) | 0.82 | 1.89 | |
B-dimension (°) | 3.01 (3.98) | 0.841 (0.637, 0.931) | 1.81 | 4.20 |
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Carmona-Pérez, C.; Pérez-Ruiz, A.; Garrido-Castro, J.L.; Vidal, F.T.; Alcaraz-Clariana, S.; García-Luque, L.; Rodrigues-de-Souza, D.P.; Alburquerque-Sendín, F. Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy. Diagnostics 2020, 10, 661. https://doi.org/10.3390/diagnostics10090661
Carmona-Pérez C, Pérez-Ruiz A, Garrido-Castro JL, Vidal FT, Alcaraz-Clariana S, García-Luque L, Rodrigues-de-Souza DP, Alburquerque-Sendín F. Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy. Diagnostics. 2020; 10(9):661. https://doi.org/10.3390/diagnostics10090661
Chicago/Turabian StyleCarmona-Pérez, Cristina, Alberto Pérez-Ruiz, Juan L. Garrido-Castro, Francisco Torres Vidal, Sandra Alcaraz-Clariana, Lourdes García-Luque, Daiana Priscila Rodrigues-de-Souza, and Francisco Alburquerque-Sendín. 2020. "Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy" Diagnostics 10, no. 9: 661. https://doi.org/10.3390/diagnostics10090661