Exploring Positional Performance and Force Control in a Bimanual Lifting Task Among Children with Neurodevelopmental Disabilities: A Cross-Sectional Study

Children with neurodevelopmental disabilities often struggle with motor control and stability, impacting their ability to perform functional tasks such as lifting and carrying objects. This study explores positional performance during bimanual box-lifting tasks in children aged 9-18 years with neurodevelopmental disabilities. A total of 83 participants, including 62 with unilateral spastic cerebral palsy and 21 with non-unilateral spastic cerebral palsy, performed tasks using the Activity of Daily Living Testing and Training Device. Tasks were conducted at maximal (80-100% force) and submaximal (40-80% force) levels of force control, with positional performance measured in six directions using Inertial Measurement Unit sensors. Statistical analyses included the Wilcoxon signed-rank test for levels of force control comparisons, Kruskal-Wallis tests for group differences, and Spearman correlations to assess relationships between maximal and submaximal performance. The results revealed that four of six positional parameters were worse in the maximal zone than in the submaximal zone (p < 0.05), highlighting the challenges of higher force demands. Additionally, positive correlations between maximal and submaximal performance suggest consistency across levels of force control. Maximal levels of force control increased variability, with submaximal performance proven to be a reliable predictor of maximal capabilities. This finding offers a safer and more efficient method for assessing motor performance. Overall, these results underscore the importance of targeted rehabilitation strategies focused on improving stability and precision in children with neurodevelopmental disabilities so they can perform daily tasks more independently.