Bimanual upper limb activity in children with typical development and unilateral cerebral palsy: validation of a triaxial accelerometer approach

Bimanual upper limb activity is crucial for many activities of daily living, such as self‐care, work, leisure, social communication. These activities encompass both gross and fine movements, and involve a tight form of cooperation between the upper limbs. The cooperation implies in the majority of cases by a distinction between right and left hand, since one conducts the action, whereas the contralateral helps in completing the motor task, playing a secondary role. For this reason, the two hands are commonly called ‘dominant’ and ‘non dominant’, respectively. In unilateral cerebral palsy (UCP) quantitatively measurement of the asymmetry in the use of upper limbs (ULs) could overcome the limitation of many outcome measures in which scores are dependent on the experience and training of the therapist. The main aim of this study was to determine the validity of Actigraph GXT3+ to measure asymmetry in the use of the two ULs during the Assisting Hand Assessment (AHA) in children and adolescents with UCP aged 5–19 years, compared to age‐matched typically developing subjects (TD).