Windmill-task as a New Quantitative and Objective Assessment for Mirror Movements in Unilateral Cerebral Palsy: A Pilot Study

Arch Phys Med Rehabil. 2018 Aug;99(8):1547-1552. doi: 10.1016/j.apmr.2018.01.035. Epub 2018 Mar 23.

Abstract

Objective: To introduce the Windmill-task, a new objective assessment tool to quantify the presence of mirror movements (MMs) in children with unilateral cerebral palsy (UCP), which are typically assessed with the observation-based Woods and Teuber scale (W&T).

Design: Prospective, observational, cohort pilot study.

Setting: Children's hospital.

Participants: Prospective cohort of children (N=23) with UCP (age range, 6-15y, mean age, 10.5±2.7y).

Interventions: Not applicable.

Main outcome measures: The concurrent validity of the Windmill-task is assessed, and the sensitivity and specificity for MM detection are compared between both assessments. To assess the concurrent validity, Windmill-task data are compared with W&T data using Spearman rank correlations (ρ) for 2 conditions: affected hand moving vs less affected hand moving. Sensitivity and specificity are compared by measuring the mean percentage of children being assessed inconsistently across both assessments.

Results: Outcomes of both assessments correlated significantly (affected hand moving: ρ=.520; P=.005; less affected hand moving: ρ=.488; P=.009). However, many children displayed MMs on the Windmill-task, but not on the W&T (sensitivity: affected hand moving: 27.5%; less affected hand moving: 40.6%). Only 2 children displayed MMs on the W&T, but not on the Windmill-task (specificity: affected hand moving: 2.9%; less affected hand moving: 1.4%).

Conclusions: The Windmill-task seems to be a valid tool to assess MMs in children with UCP and has an additional advantage of sensitivity to detect MMs.

Keywords: Child; Movement; Rehabilitation; Upper extremity.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cerebral Palsy / physiopathology*
  • Child
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Prospective Studies