Hilde Feys

• Head of Department at KU Leuven

Aim To explore daily‐life reported executive functions and their relation with bimanual performance in children with unilateral cerebral palsy (CP). Method In this cross‐sectional study of 46 children with unilateral CP (mean age 11 years 10 months, standard deviation 2 years 10 months), executive functions were evaluated using the Behavior Rating...

Transcranial direct current stimulation (tDCS) may facilitate neuroplasticity but with a limited effect when administered while stroke patients are at rest. Muscle-computer interface (MCI) training is a promising approach for training stroke patients even if they cannot produce overt movements. However, using tDCS to enhance MCI training has not be...

Background: Visual information is crucial for performing goal-directed movements in daily life. Aims: To investigate the relation between visual functions, functional vision, and bimanual function in children with unilateral cerebral palsy (uCP). Methods and procedures: In 49 children with uCP (7-15y), we investigated the relation between stereoacu...

Background Besides motor impairments, up to 90% of the children and adolescents with unilateral cerebral palsy (uCP) present with somatosensory impairments in the upper limb. As somatosensory information is of utmost importance for coordinated movements and motor learning, somatosensory impairments can further compromise the effective use of the im...

Transcranial direct current stimulation (tDCS) may facilitate neuroplasticity but with a limited effect when administered while stroke patients are at rest. Muscle-computer interface (MCI) training is a promising approach for training stroke patients even if they cannot produce overt movements. However, using tDCS to enhance MCI training has not be...

Background Robots have been proposed as tools to measure bimanual coordination in children with unilateral cerebral palsy (uCP). However, previous research only examined one task and clinical interpretation remains challenging due to the large amount of generated data. This cross-sectional study aims to examine bimanual coordination by using multip...

Background: In children with unilateral cerebral palsy (uCP), bimanual assessments mostly focus on qualitative assessments of the impaired upper limb during bimanual tasks, which do not capture the spatiotemporal coordination between both hands. Hence, we aimed to advance our understandings in spatiotemporal coordination in children with uCP compar...

Aim To investigate functional motor performance in a large cohort of young steroid‐naïve males with Duchenne muscular dystrophy (DMD) and typically developing males, and to develop specific reference curves for both groups. Also, to describe associations between anthropometric values and functional motor outcomes. Method Cross‐sectional data of 19...

Background: Besides motor impairments, up to 90% of the children and adolescents with unilateral cerebral palsy (uCP) present with somatosensory impairments in the upper limb. As somatosensory information is of utmost importance for coordinated movements and motor learning, somatosensory impairments can further compromise the effective use of the i...

Background: The effects of unilateral cerebral palsy (UCP) are largely observed in the upper limb (UL), which represents the main focus of rehabilitation for this disorder. Thanks to an increment in home training and progress in technology innovative systems have been created. The Tele-UPCAT (Tele-monitored UPper Limb Children Action Observation T...

Few studies have examined the effect of intensive therapy on gross motor function and trunk control in children with cerebral palsy (CP). This study evaluated the effects of an intensive burst of therapy on the lower limbs and trunk by comparing qualitative functional and functional approaches. This study was designed as a quasi-randomized, control...

Background: Children with Developmental Coordination Disorder (DCD) face difficulties in motor learning. Action observation and imitation are strategies frequently used to teach motor skills. Aims: (1) To study action observation and imitation abilities in children with DCD compared with typically developing peers with a new protocol. (2) To gai...

Background: Dyskinetic cerebral palsy (DCP) is clinically characterized by involuntary movements and abnormal postures, which can aggravate with activity. While upper limb movement variability is often detected in the clinical picture, it remains unknown how movement patterns of individuals with DCP differ from typically developing (TD) peers. Re...

Background—Movement patterns in dyskinetic cerebral palsy (DCP) are characterized by abnormal postures and involuntary movements. Current evaluation tools in DCP are subjective and time-consuming. Sensors could yield objective information on pathological patterns in DCP, but their reliability has not yet been evaluated. The objectives of this study...

During childhood, muscle growth is stimulated by a gradual increase in bone length and body mass, as well as by other factors, such as physical activity, nutrition, metabolic, hormonal, and genetic factors. Muscle characteristics, such as muscle volume, anatomical cross‐sectional area, and muscle belly length, need to continuously adapt to meet the...

Background: Studies aiming to objectively quantify movement disorders during upper limb tasks using wearable sensors have recently increased, but there is a wide variety in described measurement and analyzing methods, hampering standardization of methods in research and clinics. Therefore, the primary objective of this review was to provide an over...

Objective The purpose of this study was to investigate differences in static and dynamic motor fatigability during grip and pinch tasks between children with unilateral spastic cerebral palsy (USCP) and children with typical development (TD) and between preferred and nonpreferred hands. Methods Fifty-three children with USCP and 53 age-matched chi...

Background Studies aiming to objectively quantify upper limb movement disorders during functional tasks using wearable sensors have recently increased, but there is a wide variety in described measurement and analyzing methods, hampering standardization of methods in research and clinics. Therefore, the primary objective of this review was to provi...

Mirror movements (MM) influence bimanual performance in children with unilateral cerebral palsy (uCP). Whilst MM are related to brain lesion characteristics and the corticospinal tract (CST) wiring pattern, the combined impact of these neurological factors remains unknown. Forty-nine children with uCP (mean age 10y6mo) performed a repetitive squeez...

Children with spastic cerebral palsy (SCP) are often treated with intramuscular Botulinum Neurotoxin type-A (BoNT-A). Recent studies demonstrated BoNT-A-induced muscle atrophy and variable effects on gait pathology. This group-matched controlled study in children with SCP compared changes in muscle morphology 8–10 weeks post-BoNT-A treatment (n = 2...

Dyskinetic cerebral palsy (DCP) is characterised by involuntary movements, and the movement patterns of children with DCP have not been extensively studied during upper limb tasks. The aim of this study is to evaluate psychometric properties of upper limb kinematics in participants with DCP and typically developing (TD) participants. In current rep...

B ackground and objectives Brain damage during early development impacts the brain structural network and its coinciding functions. Here, we explored structural brain connectomes in children with unilateral cerebral palsy and its relation to sensory-motor function using a novel semi-automated graph theory analysis, investigating both hemispheres....

Impaired hand proprioception can lead to difficulties in performing fine motor tasks, thereby affecting activities of daily living. The majority of children with unilateral cerebral palsy (uCP) experience proprioceptive deficits, but accurately quantifying these deficits is challenging due to the lack of sensitive measurement methods. Robot-assiste...

Aim Dyskinetic cerebral palsy (DCP) is characterised by involuntary movements, and the movement patterns of children with DCP have not been extensively studied during upper limb tasks. The aim of this study is to evaluate psychometric properties of upper limb kinematics in participants with DCP and typically developing (TD) participants. Methods T...

Background This study aimed to analyze the reliability of concentric isokinetic strength assessments (knee and hip) using the Biodex System 4 in healthy children and assess the association with functional strength tests (sit-to-stand [STS], lateral-step-up [LSU]). Methods 19 children (6–12 years) were included. Knee and hip flexion and extension,...

Aim We explored the psychometric properties of the recently developed Tyneside Pegboard Test (TPT) for unimanual and bimanual dexterity in children with unilateral cerebral palsy (CP) and investigated the impact of sensorimotor impairments on manual dexterity. Method In this cross‐sectional study, the TPT was assessed in 49 children with unilatera...

Aims: To develop a new protocol for the assessment of action observation (AO) abilities and imitation of meaningful and non-meaningful gestures, to examine its psychometric properties in children with DCD and typically developing (TD) children. Background: For learning manual skills, AO and imitation are considered fundamental abilities. Knowled...

Background: Muscle weakness in children and adolescents with cerebral palsy (CP) can affect daily life activities, even more if functional capabilities are poor. Also core stability plays an important role in distal force generation. Aim: The main purpose of this study was to investigate the reliability of functional tests of the lower limbs and...

In children with unilateral cerebral palsy (uCP), the presence of sensorimotor impairments compromises active involvement of the hand in daily life, impeding self-care independence. The variability in upper limb problems among these children is substantial, ranging from minor deficiencies with in-hand manipulation to no active grasp. This variabili...

Objectives: To map the presence, severity, and distribution of spasticity and passive range of motion (pROM) deviations in dyskinetic cerebral palsy (DCP), and to explore their relation with dystonia, choreoathetosis, and functional abilities. Methods: This cross-sectional study included 53 participants with DCP. Spasticity was assessed with the M...

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP in a ran...

This study explored the role of lesion timing (periventricular white matter versus cortical and deep grey matter lesions) and type of corticospinal tract (CST) wiring pattern (contralateral, bilateral, ipsilateral) on white matter characteristics of the CST, medial lemniscus, superior thalamic radiations and sensorimotor transcallosal fibers in chi...

Background Conventional Structural Magnetic Resonance Imaging (sMRI) is a mainstay in Cerebral Palsy (CP) diagnosis. Aims A systematic literature review was performed with the aim to investigate the relationship between structural brain lesions identified by sMRI and motor outcomes in children with CP. Methods Fifty-eight studies were included. T...

This study explored the role of lesion timing (periventricular white matter versus cortical and deep grey matter lesions) and type of corticospinal tract (CST) wiring pattern (contralateral, bilateral, ipsilateral) on white matter characteristics of the CST, medial lemniscus, superior thalamic radiations and sensorimotor transcallosal fibers in chi...

The recent development of the Tyneside Pegboard Test (TPT) allows assessing both unimanual and bimanual dexterity in children with unilateral cerebral palsy (uCP). Our aim was to investigate differences in dexterity between Manual Ability Classification System (MACS) levels and the impact of sensorimotor impairments on unimanual and bimanual dexter...

Mirror movements (MM) influence bimanual function in children with unilateral cerebral palsy (uCP). MMs are related to brain lesion characteristics and the corticospinal tract (CST) wiring pattern. However, the combined impact of these neurological factors remains unknown, which was investigated in this study. Forty-nine children with uCP (mean ag...

Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). Additional training targeting motor planning deficits might be of additional value. Here, we investigated the combined effect of action-observation training (AOT) to CIMT and identified factors influencing treatment response. For...

Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). Action-observation training (AOT) might be of additional value as these children also show motor planning deficits. Here, we investigated the combined value of AOT to CIMT on UL kinematics in children with uCP. Thirty-six childre...

Background. Mirror movements (MM) influence bimanual performance in children with unilateral cerebral palsy (uCP). Whilst MM are related to brain lesion characteristics and the corticospinal tract (CST) wiring pattern, the combined impact of these neurological factors remains unknown. Objective. To investigate the combined impact of neurological fa...

Background Diffusion magnetic resonance imaging (dMRI) is able to detect, localize and quantify subtle brain white matter abnormalities that may not be visible on conventional structural MRI. Over the past years, a growing number of studies have applied dMRI to investigate structure-function relationships in children with cerebral palsy (CP). Aim...

Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatme...

This study is the first to examine prosthesis design and appearance in healthy children towards prosthesis for children using a questionnaire. 119 typically developing children between the age of seven and twelve years were included. Their reactions were evoked by priming them to several types of assistive devices. Most of the participants clearly...

Background To systematically review and analyse the effects of Action Observation Training on adults and children with brain damage. Methods Seven electronic databases (Cochrane, EBSCO, Embase, Eric, PubMed, Scopus and Web of Science) were searched up to 16 September 2018 to select Randomized Controlled Trials focused on adults and children with b...

Corticospinal tract integrity after stroke has been widely investigated through the evaluation of fibres descending from the primary motor cortex. However, about half of the corticospinal tract is composed by sub-pathways descending from premotor and parietal areas, to which damage may play a more specific role in motor impairment and recovery, par...

Aim To assess test–retest reliability of the Dyskinesia Impairment Scale (DIS) in children and young adults with dyskinetic cerebral palsy (CP). Method Dystonia and choreoathetosis were assessed in 15 participants with dyskinetic CP (13 males, 2 females; age range 5–22y, mean 14y, SD 4y) using the DIS in two separate sessions over 7 days. Exclusio...

The aim of this paper is to provide a clinically applicable overview of different tone reducing modalities and how these can interact with or augment concurrent physical therapy (PT). Botulinum toxin (BoNT), oral tone-regulating medication, intrathecal baclofen (ITB), and selective dorsal rhizotomy are discussed within a physiotherapeutic context a...

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP. Thirty-...

Introduction Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatmen...

In children with unilateral cerebral palsy (uCP), the corticospinal tract (CST)-wiring patterns may differ (contralateral, ipsilateral or bilateral), partially determining motor deficits. However, the impact of such CST-wiring on functional connectivity remains unknown. Here, we explored resting-state sensorimotor functional connectivity in 26 uCP...

The three-minute walk test (3MWT) and timed function tests (TFTs) (rise from floor, 10 m run, climbing and descending four stairs) are currently used to evaluate functional capacity in young boys with neuromuscular disorders. This study aimed to generate normative data in healthy boys aged 2.5 up to 6 years for these tests and to provide percentile...

This commentary is on the original article by Russo et al. on pages 1080–1086 of this issue.

In children with unilateral cerebral palsy (uCP), the corticospinal tract (CST) wiring patterns may differ (contralateral, ipsilateral or bilateral), partially determining motor deficits. However, the impact of such CST wiring on functional connectivity remains unknown. Here, we explored differences in functional connectivity of the resting-state s...

Background: This cross-sectional study aims to investigate the presence and severity of overflow movements of dystonia and choreoathetosis in dyskinetic cerebral palsy (CP) and to assess the relationship of overflow movements with functional classification scales. Methods: Fifty-two subjects with dyskinetic CP were included. Presence and severity o...

Knowledge on long-term evolution of upper limb function in children with unilateral cerebral palsy (CP) is scarce. The objective was to report the five-year evolution in upper limb function and identify factors influencing time trends. Eighty-one children (mean age 9 y and 11 mo, SD 3 y and 3 mo) were assessed at baseline with follow-up after 6 mon...

Background Aberrant functional connectivity in brain networks associated with motor impairment after stroke is well described, but little is known about the association with somatosensory impairments. Aim The objective of this cross-sectional observational study was to investigate the relationship between brain functional connectivity and severity...

Prevalence of ROI's that showed overlap with the lesions of each patient. ROI: region of interest. (DOCX)

Overview of lesion location for each patient. ACM: arteria cerebri media; ACA: arteria cerebri anterior; ACP: arteria cerebri posterior; BA: arteria basilaris; C: cortical lesion; SC: subcortical lesion. (DOCX)

Brain lesion characteristics (timing, location, and extent) and the type of corticospinal tract (CST) wiring have been proposed as determinants of upper limb (UL) motor function in unilateral cerebral palsy (uCP), yet an investigation of the relative combined impact of these factors on both motor and sensory functions is still lacking. Here, we fir...

Background: Upper limb (UL) deficits in children with unilateral cerebral palsy (uCP) have traditionally been targeted with motor execution treatment models, such as modified Constraint-Induced Movement Therapy (mCIMT). However, new approaches based on a neurophysiological model such as Action-Observation Training (AOT) may provide new opportuniti...

Background and aim Understanding the maturation of upper limb (UL) movement characteristics in typically developing (TD) children is key to explore UL deficits in those with neurodevelopmental disorders. Three-dimensional motion analysis (3DMA) offers a reliable tool to comprehensively evaluate UL motion. However, studies thus far mainly focused on...

Figs (S1-S8) representing the upper limb movement patterns of all four age-groups during (S1) reaching forward, (S2) reaching upward, (S3) reaching sideways, (S4) reach-to-grasp a sphere, (S5) reach-to-grasp a vertically oriented cylinder, (S6) hand-to-mouth, (S7) hand-to-head, (S8) hand-to-shoulder. Joints are presented in rows, from top to bottom...

Figs (S9-S16) representing the effect sizes (Cohen’s d) of the pair-wise post-hoc comparisons during (S9) reaching forward, (S10) reaching upward, (S11) reaching sideways, (S12) reach-to-grasp a sphere, (S13) reach-to-grasp a vertically oriented cylinder, (S14) hand-to-mouth, (S15) hand-to-head, (S16) hand-to-shoulder. Joints are presented in rows,...

Introduction: A new rehabilitative approach, called UPper Limb Children Action Observation Training (UPCAT), based on the principles of action observation training (AOT), has provided promising results for upper limb rehabilitation in children with unilateral cerebral palsy (UCP). This study will investigate if a new information and communication...

Objective: To investigate interrater and intrarater reliability, measurement error and convergent and discriminative validity of the Adult Assisting Hand Assessment Stroke (Ad-AHA Stroke). Design: Cross-sectional observational study SETTING: Seven stroke rehabilitation centers PARTICIPANTS: A total of 118 stroke survivors (reliability sample: n=...

Purpose: To investigate the relation between observed and perceived upper limb motor function in patients with chronic stroke. Material and methods: We investigated 32 patients at six months after stroke with the Fugl-Meyer Assessment (observed function) and hand subscale of the Stroke Impact Scale (perceived function). Spearman correlation was cal...

Background: In children with unilateral cerebral palsy (uCP) virtually nothing is known on the relation between structural brain damage and upper limb (UL) kinematics quantified with three-dimensional movement analysis (3DMA). This explorative study aimed to (1) investigate differences in UL kinematics between children with different lesion timings...

Background: To investigate the effects of a three month active cycling program followed by coaching on physical activity in subacute stroke patients. Methods: Patients (n = 59; mean age =65.4 ± 10.3) aged ≤80 years with first stroke and able to cycle at 50 revolutions/minute enrolled 3–10 weeks post stroke. Patients were randomly allocated to three...

Upper limb three-dimensional movement analysis (UL-3DMA) offers a reliable and valid tool to evaluate movement patterns in children with unilateral cerebral palsy (uCP). However, it remains unknown to what extent the underlying motor impairments explain deviant movement patterns. Such understanding is key to develop efficient rehabilitation program...

Cerebral palsy is the most frequent cause of severe physical disability in childhood. Dyskinetic cerebral palsy (DCP) is the second most common type of cerebral palsy after spastic forms. DCP is typically caused by non-progressive lesions to the basal ganglia or thalamus, or both, and is characterised by abnormal postures or movements associated wi...