Useless, measurement does NOTHING for getting to 100% recovery.
Clinical usefulness and validity of robotic measures of reaching movement in hemiparetic stroke patients
2015, Journal of neuroengineering and rehabilitation
Eri Otaka 1,
Eri Otaka 1,
Yohei Otaka 1*,
Shoko Kasuga 1,
Atsuko Nishimoto 1,
Kotaro Yamazaki 1,
Michiyuki Kawakami 1,
Junichi Ushiba 2
and Meigen Liu 1
Various robotic technologies have been developed recently for objective and quantitative assessment of movement. Among them, robotic measures derived from a reaching task in the KINARM Exoskeleton device are characterized by their potential to reveal underlying motor control in reaching movements. The aim of this study was to examine the clinical usefulness and validity of these robot-derived measures in hemiparetic stroke patients.
Methods:
Fifty-six participants with a hemiparetic arm due to chronic stroke were enrolled. The robotic assessment was performed using the Visually Guided Reaching (VGR) task in the KINARM Exoskeleton, which allows free arm movements in the horizontal plane. Twelve parameters were derived based on motor control theory. The following clinical assessments were also administered: the proximal upper limb section in the Fugl-Meyer Assessment(FMA-UE(A)), the proximal upper limb part in the Stroke Impairment Assessment Set (SIAS-KM), the Modified Ashworth Scale for the affected elbow flexor muscles (MAS elbow), and seven proximal upper limb tasks in the Wolf Motor Function Test (WMFT). To explore which robotic measures represent deficits of motor control in the affected arm, the VGR parameters in the paretic arm were compared with those in the nonparetic arm using the Wilcoxon signed rank test. Then, to explore which VGR parameters were related to overall motor control regardless of the paresis, correlations between the paretic and nonparetic arms were examined. Finally, to investigate the relationships between the robotic measures and the clinical scales, correlations between the VGR parameters and clinical scales were investigated. Spearman
’
s rank correlation coefficients were used for all correlational analyses.
Results:
Eleven VGR parameters on the paretic side were significantly different from those on the non-paretic side with large effect sizes (|effect size| = 0.76–0.87). Ten VGR parameters correlated significantly with FMA-UE(A)(|r| = 0.32–0.60). Eight VGR parameters also showed significant correlations with SIAS-KM (|r| = 0.42–0.49), MASelbow (|r| = 0.44–0.48), and the Functional Ability Scale of the WMFT (|r| = 0.52–0.64).
Conclusions:
The robot-derived measures could successfully differentiate between the paretic arm and the nonparetic arm and were valid in comparison to the well-established clinical scales.
* Correspondence: otaka119@mac.com
1
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, JapanFull list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERINGAND REHABILITATION
© 2015 Otaka et al.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Otaka
et al. Journal of NeuroEngineering and Rehabilitation
DOI 10.1186/s12984-015-0059-8
Abstract
Background:Various robotic technologies have been developed recently for objective and quantitative assessment of movement. Among them, robotic measures derived from a reaching task in the KINARM Exoskeleton device are characterized by their potential to reveal underlying motor control in reaching movements. The aim of this study was to examine the clinical usefulness and validity of these robot-derived measures in hemiparetic stroke patients.
Methods:
Fifty-six participants with a hemiparetic arm due to chronic stroke were enrolled. The robotic assessment was performed using the Visually Guided Reaching (VGR) task in the KINARM Exoskeleton, which allows free arm movements in the horizontal plane. Twelve parameters were derived based on motor control theory. The following clinical assessments were also administered: the proximal upper limb section in the Fugl-Meyer Assessment(FMA-UE(A)), the proximal upper limb part in the Stroke Impairment Assessment Set (SIAS-KM), the Modified Ashworth Scale for the affected elbow flexor muscles (MAS elbow), and seven proximal upper limb tasks in the Wolf Motor Function Test (WMFT). To explore which robotic measures represent deficits of motor control in the affected arm, the VGR parameters in the paretic arm were compared with those in the nonparetic arm using the Wilcoxon signed rank test. Then, to explore which VGR parameters were related to overall motor control regardless of the paresis, correlations between the paretic and nonparetic arms were examined. Finally, to investigate the relationships between the robotic measures and the clinical scales, correlations between the VGR parameters and clinical scales were investigated. Spearman
’
s rank correlation coefficients were used for all correlational analyses.
Results:
Eleven VGR parameters on the paretic side were significantly different from those on the non-paretic side with large effect sizes (|effect size| = 0.76–0.87). Ten VGR parameters correlated significantly with FMA-UE(A)(|r| = 0.32–0.60). Eight VGR parameters also showed significant correlations with SIAS-KM (|r| = 0.42–0.49), MASelbow (|r| = 0.44–0.48), and the Functional Ability Scale of the WMFT (|r| = 0.52–0.64).
Conclusions:
The robot-derived measures could successfully differentiate between the paretic arm and the nonparetic arm and were valid in comparison to the well-established clinical scales.
* Correspondence: otaka119@mac.com
1
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, JapanFull list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERINGAND REHABILITATION
© 2015 Otaka et al.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Otaka
et al. Journal of NeuroEngineering and Rehabilitation
DOI 10.1186/s12984-015-0059-8
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