End-point kinematics using virtual reality explaining upper limb impairment and activity capacity in stroke

The Fugl-Meyer upper extremity scale has no objective distinction for changes in ability and thus would be useless as a measurement tool.

Using the Action Research Arm Test for validation is not useful, it is subjective.

 

 

End-point kinematics using virtual reality explaining upper limb impairment and activity capacity in stroke

• Netha HussainEmail authorView ORCID ID profile,
• Katharina S. Sunnerhagen and
• Margit Alt Murphy

Journal of NeuroEngineering and Rehabilitation201916:82

https://doi.org/10.1186/s12984-019-0551-7

©  The Author(s). 2019

• Received: 11 October 2018
• Accepted: 12 June 2019
• Published: 1 July 2019

Abstract

Background

For evaluation of upper limb impairment and activity capacity, Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) are recommended to be included in stroke trials. To improve the understanding of mechanisms of motor recovery, and differentiate between restitution and compensation, kinematic analysis is also recommended for assessment of upper limb function after stroke.

Aim

To determine the extent to which end-point kinematic variables obtained from the target-to-target pointing task were associated with upper limb impairment or activity limitation as assessed by traditional clinical scales in individuals with stroke.

Methods

Sixty-four individuals, from acute stage up to one year after stroke, were included from the Stroke Arm Longitudinal study at the University of Gothenburg (SALGOT) cohort. They performed a target-to-target pointing task in a virtual environment using a haptic stylus which also captured the kinematic parameters. Multiple linear regression was done to determine the amount of variance explained by kinematic variables on FMA-UE and ARAT scores after controlling for confounding variables.

Results

Mean velocity and number of velocity peaks explained 11 and 9% of the FMA-UE score uniquely and 16% when taken together. Movement time and number of velocity peaks explained 13 and 10% of the ARAT score respectively.

Conclusion

The kinematic variables of movement time, velocity and smoothness explain only a part of the variance captured by using clinical observational scales, reinforcing the importance of multi-level assessment using both kinematic analysis and clinical scales in upper limb evaluation after stroke.

Trial registration

The trial was registered with register number NCT01115348 at clinicaltrials.gov, on May 4, 2010. URL: https://clinicaltrials.gov/ct2/show/NCT01115348.