Thesis Defense Date: April 29, 2026
Unilateral cerebral palsy (UCP) is a pediatric movement disorder characterized by motor impairment primarily affecting one side of the body. Clinical assessments of upper limb function are widely used but often lack precision and may be influenced by clinician subjectivity, thus creating a need for objective, reliable, and valid forms of assessment. Mobile health (mHealth) has shown promise in rehabilitation settings, due to their accessibility and user-friendly design. However, validity and reliability of these assessment tools remain largely unknown.
MoEvGame was developed to evaluate upper limb motor function. This study evaluated the reliability and validity of MoEvGame in children age 5-12 years, including those with UCP (n=10) and typically developing (TD) controls (n=40). Participants completed two lab visits where they played games and performed other standard clinical assessments. While they played the games their upper limb movements were recorded using a Vicon 3D motion capture system.
Results demonstrated strong reliability with intraclass correlation coefficient (ICC > 0.757), across game metrics. Construct validity was supported by significant differences between limbs and groups (UCP vs. TD). Concurrent validity was demonstrated with moderate correlations (r > 0.47) between game-derived measures and clinical assessments including the Box and Blocks Test and ABILHANDS. Comparison between game-derived data and motion capture data provided further support for validity.
Analysis of 3D kinematics showed a difference in range of motion (ROM) between groups, particularly in shoulder abduction/adduction and elbow pronation/supination, although no differences were observed between limbs. No correlation was found between ROM and game-derived error (RMSE), instead, distinct clustering patterns emerged, with the TD participants demonstrating greater ROM variability and the UCP participants exhibiting greater variability in RMSE.
These findings suggest that MoEvGame provides an accessible, reliable, and valid tool for assessment of upper limb function in children with UCP. Integrating game-based metrics with kinematics may provide new clinically meaningful insights into motor impairments and methods of assessment.
