A
major problem in neurorehabilitation is the lack of objective outcomes
to measure movement quality. Movement quality features, such as
coordination and stability, are essential for everyday motor actions.
These features allow reacting to continuously changing environment or to
resist external perturbations. Neurological disorders affect movement
quality, leading to functionally impaired movements. Recent findings
suggest that the central nervous system organizes motor elements (eg,
muscles, joints, fingers) into task-specific ensembles to stabilize
motor tasks performance. A method to quantify this feature has been
previously developed based on the uncontrolled manifold (UCM)
hypothesis. UCM quantifies movement quality in a spatial-temporal domain
using intertrial analysis of covariation between motor elements. In
this point-of-view article, we first describe major obstacles (eg, the
need for group analysis) that interfere with UCM application in clinical
settings. Then, we propose a process of quantifying movement quality
for a single individual with a novel use of bootstrapping simulations
and UCM analysis. Finally, we reanalyze previously published data from
individuals with neurological disorders performing a wide range of motor
tasks, that is, multi-digit pressing and postural balance tasks. Our
method allows one to assess motor quality impairments in a single
individual and to detect clinically important motor behavior changes.
Our solution may be incorporated into a clinical setting to assess
sensorimotor impairments, evaluate the effects of specific neurological
treatments, or track movement quality recovery over time. We also
recommended the proposed solution to be used jointly with a typical
statistical analysis of UCM parameters in cohort studies.
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