{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:20:26Z","timestamp":1760145626108,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>This study evaluates the R3THA\u2122 assessment protocol (R3THA-AP\u2122), a technology-supported testing module for personalized rehabilitation in children with cerebral palsy (CP). It focuses on the reliability and validity of the R3THA-AP in assessing hand and arm function, by comparing kinematic assessments with standard clinical assessments. Conducted during a 4-week summer camp, the study assessed the functional and impairment levels of children with CP aged 3\u201318. The findings suggest that R3THA is more reliable for children aged 8 and older, indicating that age significantly influences the protocol\u2019s effectiveness. The results also showed that the R3THA-AP\u2019s kinematic measurements of hand and wrist movements are positively correlated with the Box and Blocks Test Index (BBTI), reflecting hand function and dexterity. Additionally, the R3THA-AP\u2019s accuracy metrics for hand and wrist activities align with the Melbourne Assessment 2\u2019s Range of Motion (MA2-ROM) scores, suggesting a meaningful relationship between R3THA-AP data and clinical assessments of motor skills. However, no significant correlations were observed between the R3THA-AP and MA2\u2019s accuracy and dexterity measurements, indicating areas for further research. These findings validate the R3THA-AP\u2019s utility in assessing motor abilities in CP patients, supporting its integration into clinical practice.<\/jats:p>","DOI":"10.3390\/s24155013","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T16:14:58Z","timestamp":1722615298000},"page":"5013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the Kinematic Assessment Protocol Used in the Technology-Supported Neurorehabilitation System, Rehabilitation Technologies for Hand and Arm (R3THA\u2122), in Children and Teenagers with Cerebral Palsy"],"prefix":"10.3390","volume":"24","author":[{"given":"Qinyin","family":"Qiu","sequence":"first","affiliation":[{"name":"NeuroTechR3, Inc., 211 Warren Street, Newark, NJ 07103, USA"},{"name":"Rutgers Biomedical and Health Sciences, Rutgers University, 65 Bergen St, Newark, NJ 07107, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2062-6663","authenticated-orcid":false,"given":"Ashley J.","family":"Mont","sequence":"additional","affiliation":[{"name":"NeuroTechR3, Inc., 211 Warren Street, Newark, NJ 07103, USA"},{"name":"Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr Martin Luther King Jr Blvd, Newark, NJ 07102, USA"}]},{"given":"Amanda","family":"Gross","sequence":"additional","affiliation":[{"name":"NeuroTechR3, Inc., 211 Warren Street, Newark, NJ 07103, USA"}]},{"given":"Gerard","family":"Fluet","sequence":"additional","affiliation":[{"name":"Rutgers Biomedical and Health Sciences, Rutgers University, 65 Bergen St, Newark, NJ 07107, USA"}]},{"given":"Sergei","family":"Adamovich","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr Martin Luther King Jr Blvd, Newark, NJ 07102, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0306-9372","authenticated-orcid":false,"given":"Mee","family":"Eriksson","sequence":"additional","affiliation":[{"name":"NeuroTechR3, Inc., 211 Warren Street, Newark, NJ 07103, USA"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"ref_1","first-page":"113","article-title":"Neurodevelopmental disabilities in pediatrics and child neurology: Child development training for the future","volume":"1","author":"Accardo","year":"2008","journal-title":"J. Pediatr. Rehabil. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1111\/dmcn.14141","article-title":"Interventions to improve upper limb function for children with bilateral cerebral palsy: A systematic review","volume":"61","author":"Plasschaert","year":"2019","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/1440-1630.12666","article-title":"What is the threshold dose of upper limb training for children with cerebral palsy to improve function? A systematic review","volume":"67","author":"Jackman","year":"2020","journal-title":"Aust. Occup. Ther. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e36842","DOI":"10.2196\/36842","article-title":"Telehealth and remote interventions for children with cerebral palsy: Scoping review","volume":"9","author":"Morrow","year":"2022","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Tigrini, A., Ranaldi, S., Verdini, F., Mobarak, R., Scattolini, M., Conforto, S., Schmid, M., Burattini, L., Gambi, E., and Fioretti, S. (2024). Intelligent Human\u2013Computer Interaction: Combined Wrist and Forearm Myoelectric Signals for Handwriting Recognition. Bioengineering, 11.","DOI":"10.3390\/bioengineering11050458"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"58006","DOI":"10.1109\/ACCESS.2023.3279735","article-title":"Handwritten digits recognition from sEMG: Electrodes location and feature selection","volume":"11","author":"Tigrini","year":"2023","journal-title":"IEEE Access"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1186\/s12984-020-00789-w","article-title":"Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training","volume":"17","author":"Qiu","year":"2020","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1080\/01942638.2022.2064203","article-title":"Acceptability of pediatric telerehabilitation interventions provided by physical therapists and occupational therapists\u2014A scoping review","volume":"42","author":"Dostie","year":"2022","journal-title":"Phys. Occup. Ther. Pediatr."},{"key":"ref_9","first-page":"371","article-title":"Motivation in pediatric motor rehabilitation: A systematic search of the literature using the self-determination theory as a conceptual framework","volume":"21","author":"Meyns","year":"2018","journal-title":"Dev. Neurorehabilit."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jht.2019.03.012","article-title":"Leap Motion Controller-based training for upper extremity rehabilitation in children and adolescents with physical disabilities: A randomized controlled trial","volume":"33","author":"Tarakci","year":"2020","journal-title":"J. Hand Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s13760-020-01400-8","article-title":"Upper extremity rehabilitation using video games in cerebral palsy: A randomized clinical trial","volume":"121","author":"Avcil","year":"2021","journal-title":"Acta Neurol. Belg."},{"key":"ref_12","first-page":"8984379","article-title":"Novel Virtual Environment for Alternative Treatment of Children with Cerebral Palsy","volume":"2016","author":"Fernandes","year":"2016","journal-title":"Comput. Intell. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00001416-201110000-00011","article-title":"Virtual reality in the assessment and treatment of children with motor impairment: A systematic review","volume":"25","author":"Laufer","year":"2011","journal-title":"J. Phys. Ther. Educ."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Abtahi, P., Hough, S.Q., Landay, J.A., and Follmer, S. (May, January 29). Beyond being real: A sensorimotor control perspective on interactions in virtual reality. Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems, New Orleans, LA, USA.","DOI":"10.1145\/3491102.3517706"},{"key":"ref_15","first-page":"32","article-title":"Validity and reliability of leap motion controller for assessing grasping and releasing finger movements","volume":"17","author":"Okazaki","year":"2017","journal-title":"J. Ergon. Technol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Butt, A.H., Rovini, E., Dolciotti, C., Bongioanni, P., De Petris, G., and Cavallo, F. (2017, January 17\u201320). Leap motion evaluation for assessment of upper limb motor skills in Parkinson\u2019s disease. Proceedings of the 2017 International Conference on Rehabilitation Robotics (ICORR), London, UK.","DOI":"10.1109\/ICORR.2017.8009232"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"MontJohnson, A., Cronce, A., Qiu, Q., Patel, J., Eriksson, M., Merians, A., Adamovich, S., and Fluet, G. (2023). Laboratory-Based Examination of the Reliability and Validity of Kinematic Measures of Wrist and Finger Function Collected by a Telerehabilitation System in Persons with Chronic Stroke. Sensors, 23.","DOI":"10.3390\/s23052656"},{"key":"ref_18","first-page":"245","article-title":"Critical values for Spearman\u2019s rank order correlation","volume":"14","author":"Ramsey","year":"1989","journal-title":"J. Educ. Stat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/j.1469-8749.2003.tb00911.x","article-title":"Melbourne Assessment of Unilateral Upper Limb Function: Construct validity and correlation with the Pediatric Evaluation of Disability Inventory","volume":"45","year":"2003","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"312","DOI":"10.5014\/ajot.2013.006643","article-title":"Norm scores of the box and block test for children ages 3-10 years","volume":"67","author":"Steenbergen","year":"2013","journal-title":"Am. J. Occup. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"386","DOI":"10.5014\/ajot.39.6.386","article-title":"Adult norms for the Box and Block Test of manual dexterity","volume":"39","author":"Mathiowetz","year":"1985","journal-title":"Am. J. Occup. Ther."},{"key":"ref_22","unstructured":"Tryfonas, T., and Askoxylakis, I. (2015). Leap Motion Controller for Authentication via Hand Geometry and Gestures. Human Aspects of Information Security, Privacy, and Trust, Springer International Publishing."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Martinie, O., Mercier, C., Gordon, A.M., and Robert, M.T. (2021). Upper Limb Motor Planning in Individuals with Cerebral Palsy Aged between 3 and 21 Years Old: A Systematic Review. Brain Sci., 11.","DOI":"10.3390\/brainsci11070920"},{"key":"ref_24","unstructured":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (2024, May 30). Middle Childhood (6\u20138 Years of Age), Available online: https:\/\/www.cdc.gov\/ncbddd\/childdevelopment\/positiveparenting\/middle.html."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1016\/j.jbiomech.2016.04.006","article-title":"Validation of the Leap Motion Controller using markered motion capture technology","volume":"49","author":"Smeragliuolo","year":"2016","journal-title":"J. Biomech."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Choi, J.Y., Rha, D.W., Kim, S.A., and Park, E.S. (2020). The Dynamic Thumb-in-Palm Pattern in Children with Spastic Cerebral Palsy and Its Effects on Upper Limb Function. Children, 8.","DOI":"10.3390\/children8010017"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2174\/1874325001509010057","article-title":"Test-retest reliability and convergent validity of a computer based hand function test protocol in people with arthritis","volume":"9","author":"Srikesavan","year":"2015","journal-title":"Open Orthop. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12984-021-00865-9","article-title":"Validity, reliability, and sensitivity to motor impairment severity of a multi-touch app designed to assess hand mobility, coordination, and function after stroke","volume":"18","author":"Llorens","year":"2021","journal-title":"J. NeuroEng. Rehabil."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/15\/5013\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:29:12Z","timestamp":1760110152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/15\/5013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,2]]},"references-count":28,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["s24155013"],"URL":"https:\/\/doi.org\/10.3390\/s24155013","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2024,8,2]]}}}