{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:19:22Z","timestamp":1780085962517,"version":"3.54.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T00:00:00Z","timestamp":1709337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002202","name":"Toronto Rehabilitation Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002202","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate wearable sensors for measuring functional hand use in children with unilateral cerebral palsy (CP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Dual wrist\u2010worn accelerometry data were collected from three females and seven males with unilateral CP (mean age\u2009=\u200910\u2009years 2\u2009months [SD 3\u2009years]) while performing hand tasks during video\u2010recorded play sessions. Video observers labelled instances of functional and non\u2010functional hand use. Machine learning was compared to the conventional activity count approach for identifying unilateral hand movements as functional or non\u2010functional. Correlation and agreement analyses compared the functional usage metrics derived from each method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The best\u2010performing machine learning approach had high precision and recall when trained on an individual basis (F<jats:sub>1<\/jats:sub>\u2009=\u20090.896\u2009[SD\u20090.043]). On an individual basis, the best\u2010performing classifier showed a significant correlation (<jats:italic>r<\/jats:italic>\u2009=\u20090.990, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and strong agreement (bias\u2009=\u20090.57%, 95% confidence interval\u2009=\u2009\u22124.98 to 6.13) with video observations. When validated in a leave\u2010one\u2010subject\u2010out scenario, performance decreased significantly (F<jats:sub>1<\/jats:sub>\u2009=\u20090.584\u2009[SD 0.076]). The activity count approach failed to detect significant differences in non\u2010functional or functional hand activity and showed no significant correlation or agreement with the video observations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>With further development, wearable accelerometry combined with machine learning may enable quantitative monitoring of everyday functional hand use in children with unilateral CP.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Wearable (wrist\u2010worn) accelerometry with machine learning shows potential for measuring functional hand use in children with unilateral cerebral palsy.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Traditional activity count accelerometry cannot distinguish functional from non\u2010functional hand use.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.15895","type":"journal-article","created":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T08:35:22Z","timestamp":1709368522000},"page":"1380-1389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Measuring functional hand use in children with unilateral cerebral palsy using accelerometry and machine learning"],"prefix":"10.1111","volume":"66","author":[{"given":"Sunaal P.","family":"Mathew","sequence":"first","affiliation":[{"name":"Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital  Toronto ON Canada"},{"name":"Institute of Biomedical Engineering University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn","family":"Dawe","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute University of Toronto  Toronto ON 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