https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-017-0329-8
- Jeffrey M. KenzieEmail author,
- Jennifer A. Semrau,
- Michael D. Hill,
- Stephen H. Scott and
- Sean P. Dukelow
Journal of NeuroEngineering and Rehabilitation201714:114
© The Author(s). 2017
Received: 16 May 2017
Accepted: 31 October 2017
Published: 13 November 2017
Abstract
Background
Proprioception is the sense of
the position and movement of our limbs, and is vital for executing
coordinated movements. Proprioceptive disorders are common following
stroke, but clinical tests for measuring impairments in proprioception
are simple ordinal scales that are unreliable and relatively crude. We
developed and validated specific kinematic parameters to quantify
proprioception and compared two common metrics, Euclidean and
Mahalanobis distances, to combine these parameters into an overall
summary score of proprioception.
Methods
We used the KINARM robotic exoskeleton to assess proprioception of the upper limb in subjects with stroke (N = 285.
Mean days post-stroke = 12 ± 15). Two aspects of proprioception
(position sense and kinesthetic sense) were tested using two
mirror-matching tasks without vision. The tasks produced 12 parameters
to quantify position sense and eight to quantify kinesthesia. The
Euclidean and Mahalanobis distances of the z-scores for these parameters
were computed each for position sense, kinesthetic sense, and overall
proprioceptive function (average score of position and kinesthetic
sense).
Results
A high proportion of stroke
subjects were impaired on position matching (57%), kinesthetic matching
(65%), and overall proprioception (62%). Robotic tasks were
significantly correlated with clinical measures of upper extremity
proprioception, motor impairment, and overall functional independence.
Composite scores derived from the Euclidean distance and Mahalanobis
distance showed strong content validity as they were highly correlated (r = 0.97–0.99).
Conclusions
We have outlined a composite
measure of upper extremity proprioception to provide a single continuous
outcome measure of proprioceptive function for use in clinical trials
of rehabilitation. Multiple aspects of proprioception including sense of
position, direction, speed, and amplitude of movement were incorporated
into this measure. Despite similarities in the scores obtained with
these two distance metrics, the Mahalanobis distance was preferred.
No comments:
Post a Comment