Standardized Measurement of Quality of Upper Limb Movement After Stroke: Consensus-Based Core Recommendations From the Second Stroke Recovery and Rehabilitation Roundtable (original) (raw)
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Systematic Review on Kinematic Assessments of Upper Limb Movements After Stroke
Stroke, 2019
Background and Purpose— Assessing upper limb movements poststroke is crucial to monitor and understand sensorimotor recovery. Kinematic assessments are expected to enable a sensitive quantification of movement quality and distinguish between restitution and compensation. The nature and practice of these assessments are highly variable and used without knowledge of their clinimetric properties. This presents a challenge when interpreting and comparing results. The purpose of this review was to summarize the state of the art regarding kinematic upper limb assessments poststroke with respect to the assessment task, measurement system, and performance metrics with their clinimetric properties. Subsequently, we aimed to provide evidence-based recommendations for future applications of upper limb kinematics in stroke recovery research. Methods— A systematic search was conducted in PubMed, Embase, CINAHL, and IEEE Xplore. Studies investigating clinimetric properties of applied metrics were...
Gait & Posture, 2015
Research question: The aims of this study were: (a) quantify the upper limb impairments in post-stroke patients; (b) quantitatively evaluate the effectiveness of an upper limb rehabilitation program; (c) gain more clinically meaningful information using kinematic analysis in addition to clinical assessment. Introduction: The motor functions and the effects of rehabilitative treatments are measured using clinical tests and semi-quantitative scale. The same motor behavior can be analyzed using instrumental kinematic tools that provide qualitative and quantitative information. Materials and methods: A group of 10 post-stroke patients was treated with an integrated rehabilitative program (including upper limb training); a second group of 5 post-stroke patients was treated with conventional physiotherapy. Treatment for both groups includes ten session lasting an hour and a half a day. Kinematic analysis was performed by an optoelectronic system (Vicon, UK). The subjects were asked to reach an object in a standardized setting. The task was repeated 12 times (six movements, right and left). Kinematic analysis was conducted identifying and computing specific parameters of movement duration, velocity, smoothness and upper limbs angles [1,2]. The clinical scales were Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES), Nine Hole Peg Test (NHPT) and Hand Grip Dynamometer test. All patients were assessed PRE and POST treatment. The comparison between the two sessions was done using non parametric tests (p < 0.05). Results: The upper limb kinematics evaluation showed that in PRE session the most of parameters of both groups were different from the normality ranges, with no differences between the two groups. In particular, they executed the movement slower, with higher movement duration, and with lower precision. After the treatment in the first group we found significant improvements in terms of movement duration, in particular during going phase (1.3 vs. 1.
International journal of stroke : official journal of the International Stroke Society, 2017
Finding, testing and demonstrating efficacy of new treatments for stroke recovery is a multifaceted challenge. We believe that to advance the field, neurorehabilitation trials need a conceptually rigorous starting framework. An essential first step is to agree on definitions of sensorimotor recovery and on measures consistent with these definitions. Such standardization would allow pooling of participant data across studies and institutions aiding meta-analyses of completed trials, more detailed exploration of recovery profiles of our patients and the generation of new hypotheses. Here, we present the results of a consensus meeting about measurement standards and patient characteristics that we suggest should be collected in all future stroke recovery trials. Recommendations are made considering time post stroke and are aligned with the international classification of functioning and disability. A strong case is made for addition of kinematic and kinetic movement quantification. Fur...
Journal of NeuroEngineering and Rehabilitation, 2009
In the evaluation of upper limb impairment post stroke there remains a gap between detailed kinematic analyses with expensive motion capturing systems and common clinical assessment tests. In particular, although many clinical tests evaluate the performance of functional tasks, metrics to characterise upper limb kinematics are generally not applicable to such tasks and very limited in scope. This paper reports on a novel, user-friendly methodology that allows for the assessment of both signal magnitude and timing variability in upper limb movement trajectories during functional task performance. In order to demonstrate the technique, we report on a study in which the variability in timing and signal magnitude of data collected during the performance of two functional tasks is compared between a group of subjects with stroke and a group of individually matched control subjects.
IEEE ... International Conference on Rehabilitation Robotics : [proceedings], 2011
The majority of stroke survivors have to cope with deficits in arm function, which is often monitored with subjective clinical scales during stroke rehabilitation. The aim of this study is to examine whether robotic outcome measures obtained during circle drawing are suitable to objectively measure upper extremity function of stroke survivors, especially regarding synergistic movement patterns. Stroke survivors (n = 16) and healthy subjects (n = 20) drew circles, as big and as round as possible, above a table top. Joint angles and positions of the shoulder and elbow were measured. Synergistic movement patterns were identified based on simultaneous changes of the shoulder elevation angle and elbow angle. Stroke survivors moved significantly more within synergistic movement patterns, compared to healthy subjects. Strong correlations between the proximal upper extremity part of the Fugl-Meyer (FM) scale and the use of synergistic movement patterns were found. The proposed outcome measu...
2020
BackgroundAssessing arm and hand sensorimotor impairments that are functionally relevant is essential to optimize the impact of neurorehabilitation interventions. Technology-aided assessments should provide a sensitive and objective characterization of upper limb impairments, but often provide arm weight support and neglect the importance of the hand, thereby questioning their functional relevance. The Virtual Peg Insertion Test (VPIT) addresses these limitations by quantifying arm movements and grip forces during a goal-directed manipulation task without arm weight support. The aim of this work was to evaluate the potential and robustness of the VPIT metrics to inform on sensorimotor impairments in arm and hand, and especially identify the functional relevance of the detected impairments.MethodsArm and hand sensorimotor impairments were systematically characterized in 30 chronic stroke patients using conventional clinical scales and the VPIT. For the latter, ten previously establis...
The Use of Kinetics as a Marker for Manual Dexterity After Stroke and Stroke Recovery
Topics in Stroke Rehabilitation, 2009
Stroke is the leading cause of severe, long-term disability among older adults in the United States. Unimanual motor performance of the hemiparetic limb is clearly compromised, and these declines are well documented. An often overlooked aspect of motor function for patients with stroke is the effect of unilateral motor dysfunction on bimanual motor activities. Diminished bimanual function resulting from upper extremity hemiparesis necessarily limits the patient's daily functioning. In this review we describe a bimanual dexterity task that replicates many daily activities and outline how kinetic analysis of this task may provide insight into diminished bimanual function of patients with stroke and how these variables may be useful in assessing level of recovery and rate of motor recovery associated with behavioral interventions intended to improve upper extremity function. It is argued that the use of objective kinetic measures to quantify hand function may facilitate the clinical adoption of behavioral interventions for stroke, such as constraint-induced movement therapy and other repetitive task practice-based interventions.
Neurorehabilitation and Neural Repair, 2009
Background. Human-administered clinical scales are the accepted standard for quantifying motor performance of stroke subjects. Although they are widely accepted, these measurement tools are limited by interrater and intrarater reliability and are time-consuming to apply. In contrast, robot-based measures are highly repeatable, have high resolution, and could potentially reduce assessment time. Although robotic and other objective metrics have proliferated in the literature, they are not as well established as clinical scales and their relationship to clinical scales is mostly unknown. Objective. To test the performance of linear regression models to estimate clinical scores for the upper extremity from systematic robot-based metrics. Methods. Twenty kinematic and kinetic metrics were derived from movement data recorded with the shoulder-and-elbow InMotion2 robot (Interactive Motion Technologies, Inc), a commercial version of the MIT-Manus. Kinematic metrics were aggregated into macr...