Windmill-task as a New Quantitative and Objective Assessment for Mirror Movements in Unilateral Cerebral Palsy: A Pilot Study. Academic Article uri icon


  • OBJECTIVE:To introduce the Windmill-task, a new objective assessment tool to quantify the presence of mirror movements (MMs) in children with unilateral cerebral palsy (UCP), which are typically assessed with the observation-based Woods and Teuber scale (W&T). DESIGN:Prospective, observational, cohort pilot study. SETTING:Children's hospital. PARTICIPANTS:Prospective cohort of children (N=23) with UCP (age range, 6-15y, mean age, 10.5±2.7y). INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:The concurrent validity of the Windmill-task is assessed, and the sensitivity and specificity for MM detection are compared between both assessments. To assess the concurrent validity, Windmill-task data are compared with W&T data using Spearman rank correlations (ρ) for 2 conditions: affected hand moving vs less affected hand moving. Sensitivity and specificity are compared by measuring the mean percentage of children being assessed inconsistently across both assessments. RESULTS:Outcomes of both assessments correlated significantly (affected hand moving: ρ=.520; P=.005; less affected hand moving: ρ=.488; P=.009). However, many children displayed MMs on the Windmill-task, but not on the W&T (sensitivity: affected hand moving: 27.5%; less affected hand moving: 40.6%). Only 2 children displayed MMs on the W&T, but not on the Windmill-task (specificity: affected hand moving: 2.9%; less affected hand moving: 1.4%). CONCLUSIONS:The Windmill-task seems to be a valid tool to assess MMs in children with UCP and has an additional advantage of sensitivity to detect MMs.


  • Zielinski, Ingar Marie
  • Steenbergen, Bert
  • Schmidt, Anna
  • Klingels, Katrijn
  • Simon Martinez, Cristina
  • de Water, Pascal
  • Hoare, Brian

publication date

  • 2018