Reliability, validity and discriminant ability of the instrumental indices provided by a novel planar robotic device for upper limb rehabilitation

You people are fucking worthless, telling us we need more followup research rather than completing the research properly and writing stroke protocols on it. The point of stroke research is to help patients recover. The president of that great stroke association should be forcefully communicating that to all stroke researchers.

Reliability, validity and discriminant ability of the instrumental indices provided by a novel planar robotic device for upper limb rehabilitation

• Marco GermanottaEmail authorView ORCID ID profile,
• Arianna Cruciani,
• Cristiano Pecchioli,
• Simona Loreti,
• Albino Spedicato,
• Matteo Meotti,
• Rita Mosca,
• Gabriele Speranza,
• Francesca Cecchi,
• Giorgia Giannarelli,
• Luca Padua and
• Irene Aprile

Journal of NeuroEngineering and Rehabilitation201815:39

https://doi.org/10.1186/s12984-018-0385-8

©  The Author(s). 2018

Received: 6 December 2017

Accepted: 10 May 2018

Published: 16 May 2018

Abstract

Background

In the last few years, there has been an increasing interest in the use of robotic devices to objectively quantify motor performance of patients after brain damage. Although these robot-derived measures can potentially add meaningful information about the patient’s dexterity, as well as be used as outcome measurements after the rehabilitation treatment, they need to be validated before being used in clinical practice. The present work aims to evaluate the reliability, the validity and the discriminant ability of the metrics provided by a novel robotic device for upper limb rehabilitation.

Methods

Forty-eight patients with sub-acute stroke and 40 age-matched healthy subjects were involved in this study. Clinical evaluation included: Fugl-Meyer Assessment for the upper limb, Action Research Arm Test, and Barthel Index. Robotic evaluation of the upper limb performance consisted of 14 measures of motor ability quantifying the dexterity in performing planar reaching movements. Patients were evaluated twice, one day apart, to assess the reliability of the robotic metrics, using the Intraclass Correlation Coefficient. Validity was assessed by analyzing the correlation of the robotic metrics with the clinical scales, by means of the Spearman’s Correlation Coefficient. Finally, the ability of the robotic metrics to distinguish between patients with stroke and healthy subjects was investigated with t-tests and the Effect Size.

Results

Reliability was found to be excellent for 12 measures and from moderate to good for the remaining 2. Most of the robotic indices were strongly correlated with the clinical scales, while a few showed a moderate correlation and only one was not correlated with the Barthel Index and weakly correlated with the remain two. Finally, all but one the provided metrics were able to discriminate between the two groups, with large effect sizes for most of them.

Conclusion

We found that all the robotic indices except one provided by a novel robotic device for upper limb rehabilitation are reliable, sensitive and strongly correlated both with motor and disability clinical scales. Therefore, this device is suitable as evaluation tool for the upper limb motor performance of patients with sub-acute stroke in clinical practice.

Trial registration

NCT02879279.