Reach-to-grasp interjoint coordination for moving object in children with hemiplegia.

OBJECTIVE To evaluate interjoint coordination in children with hemiplegia as they reach to grasp objects, in both static and dynamic conditions. An ad hoc robotic device was used to study the dynamic condition. DESIGN Observational study. PATIENTS Six children with hemiplegia and 6 young adults. METHODS Kinematics of the trunk and arm were studied using an optoelectronic system. In the dynamic condition the target object, a cup, was moved by the robotic device along clockwise and counterclockwise circular trajectories. RESULTS Two main strategies were used to study the onset and offset of shoulder and elbow movements and their maximum velocities. The hand velocity profile was bell-shaped in the static condition and compatible with ramp movements for the more affected side in the dynamic condition. The time to object contact was higher for the more affected side in the dynamic condition. The temporal coordination index illustrated an immature and less flexible behaviour in children's reaching in all the examined conditions. CONCLUSION Study of the hand velocity profiles, the time to object contact and the temporal coordination index highlighted, first, the dependence of upper limb interjoint coordination on task, context, residual resources and individual solution, and secondly, the sensory-motor deficit characteristics of the children's more affected side during dynamic reaching, raising the prospect of a promising training context in children with hemiplegia.