Virtual Hand-Arm Assessments for Children With Cerebral Palsy
Virtual Hand-Arm Assessments for Children With Cerebral Palsy: Helping Us to Achieve Equity in Rehabilitation Care and Research
Holland Bloorview Kids Rehabilitation Hospital
100 participants
Oct 22, 2025
OBSERVATIONAL
Conditions
Summary
Cerebral palsy (CP) affects approximately 1 in 500 Canadian children, and the majority experience hand and arm limitations that impact independence, participation in daily activities, and overall quality of life. Many children require ongoing clinical assessments and therapy delivered in specialized centres, creating significant burden related to travel, scheduling, and interruptions to school and work. Barriers such as geography, socioeconomic factors, and pandemic-related service disruptions have further limited equitable access to in-person care. Although virtual care has expanded rapidly and families have expressed strong interest in hybrid care models, there is currently no validated approach for conducting comprehensive virtual hand-arm assessments for children with CP. Virtual administration of standardized assessments, individualized goal-based evaluations, and naturalistic observation tools has not been systematically studied. Evidence is urgently needed to determine which assessments can be administered virtually, how acceptable and feasible they are for families, and whether virtual and in-person assessment methods produce equivalent results.
Eligibility
Inclusion Criteria6
- Have a diagnosis of Cerebral Palsy
- Are between 6 to 17 years old with sufficient cognitive capacity and cooperation to sit without a break for 30 minutes at a time
- MACS levels I (handles objects easily) to III (handles objects with difficulty)
- No visual limitations that would interfere with video conferencing
- Has a caregiver willing to participate and can questions about preferences
- Have an appropriate device and internet access for video conferencing
Exclusion Criteria1
- \- Active treatments (e.g. Botulinum Toxin injections or constraint therapy in the last two months, or upper extremity surgery in the last 6 months) that might impact upper limb function stability over the study period.
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Interventions
Participants complete a standardized upper-limb assessment protocol that includes two virtual videoconference assessments-delivered one week apart to evaluate test-retest reliability-and one in-person clinic assessment with the same research therapist to enable within-participant comparison of virtual and in-person scores. After each session, children, caregivers, and therapists complete brief surveys assessing feasibility, ease of completion, acceptability, and preferences. Participants also wear bilateral wrist-worn inertial sensors for five consecutive days at home to collect continuous data on naturalistic upper-limb activity. Families also provide caregiver-recorded videos of the child performing two preselected meaningful activities in their home environment. These videos are later scored using the Perceived Quality Rating Scale (PQRS) to evaluate individualized functional performance.
Locations(3)
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NCT07383753