Three-Dimensional Movement Analysis Found to Help Measure Arm Movement in Children with Unilateral CP

Unilateral (also known as hemiplegic) cerebral palsy affects the motor abilities on one side of the body. Children with unilateral CP usually have impaired upper limb function. For this reason, measuring the movement of the upper limbs is imperative in logging the progress of a patient with unilateral CP (1). 

In three-dimensional movement analysis (3DMA), a computer can track movement in real time (1). It has been commonly used for gait analysis in people with cerebral palsy. However, the 3DMA protocols that exist at present are unable to be used in bimanual situations or are too far from the gestures necessary in everyday life to be used for children with unilateral CP (2). 

French researchers at Rennes University Hospital developed a 3D bimanual protocol study specifically designed for children with unilateral CP, called “Be An Airplane Pilot.” It is essentially a video game that requires both arms to manipulate joysticks and buttons. The game proved to (1):

  • Generate spontaneous arm movements in the children
  • Mimic the types of arm movements needed in daily life
  • Require the use of both the affected and unaffected arms

The game’s 12 cameras tracked the 3D position of markers on the limbs. 

The researchers had 20 typically developing children play the game three separate times and calculated the reliability of the measurements. The reliability was over 0.90 coefficient of multiple correlation (excellent) for every type of arm movement assessed, save for wrist flexion-extension (whose CMC was 0.75, or moderate) (1). 

These results revealed that this test could be done on children with unilateral CP to measure their range of motion and the overall progress of their upper limb function. 

Related Resources


  1. Wexler, M. (2019, September 6). In Children with Unilateral CP, Way Seen to Objectively Measuring Arm Movement. Retrieved from
  2. “Be an Airplane Pilot”: A Bimanual 3D Motion Analysis in Children With Unilateral Cerebral Palsy. (n.d.). Retrieved from

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