ALTERNATIVE METHOD OF UPPER EXTREMITY FUNCTION ASSESSMENT OF STROKE PATIENTS BY ANGULAR KINEMATIC PARAMETERS

2017 ◽  
Vol 17 (05) ◽  
pp. 1750080 ◽  
Author(s):  
KRISTINA DAUNORAVIČENĖ ◽  
ARTURAS LINKEL ◽  
JURGITA ŽIŽIENĖ ◽  
JULIUS GRIŠKEVIČIUS ◽  
ALVYDAS JUOCEVIČIUS ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Joint Angle ◽  
Arm Movement ◽  
Accurate Assessment ◽  
Kinematic Parameters ◽  
Stroke Patients ◽  
Rehabilitation Programs ◽  
Angular Velocities ◽  
Patient Groups ◽  
Upper Extremity Movement

This study focuses on the functional assessment of the upper extremity of stroke patients via analysis of angular kinematics features. Amplitudes and angular velocities of multi-joint movements more precisely describe functional state at different impairment levels. However, the arm movement as a whole could be analyzed by means of joint angle–angle diagrams, which illustrate the 2D trajectory of upper extremity during movement and show the visual ranges of upper extremity in different cycles of motion. The functional range of motion of each upper extremity segment in all patient groups for more accurate assessment of capability was calculated. Moreover, we calculated the area (S) between two curves in joint angle–angle diagrams as a novel index of the complete upper extremity movement range evaluation. Our findings correspond to clinical rates and upper extremity assessment based on joint angle–angle diagrams seems to be a promising method for accurate assessment and/or predicting the outcomes of rehabilitation programs.

Abstract TMP38: Web Based Testing of Upper Extremity Movement for Patients Recovering After Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kelly Sloane ◽  
David Lin ◽  
Amanda Duffy ◽  
Julie DiCarlo ◽  
Alison Cloutier ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Arm Movement ◽  
Human Interaction ◽  
Stroke Recovery ◽  
Clear Correlation ◽  
Stroke Patients ◽  
Special Equipment ◽  
Stroke Impact Scale ◽  
Impact Scale ◽  
Patient Reported

Background: Studies of movement of the upper extremity for stroke patients currently require assessments with special equipment and trained assessors, limiting the accessibility. Hevelius is an experimental online platform designed to study human interaction with technology at a large scale. Our aim was to demonstrate the feasibility of using Hevelius for testing arm kinematics in stroke patients. Methods: Stroke patients (time from stroke 6 weeks to 1 year) with upper extremity weakness with an NIH Stroke Scale contralesional arm motor (5A or 5B) score of 2 or less were tested on Hevelius. Participants engaged in a Point-And-Click task. Thirty-two kinematic features of movement from continuous, target-driven mouse movement were collected in the arms contralesional and ipsilesional to stroke and compared to data from with health controls. Upper extremity Fugl-Meyer (UE-FM), NIH Stroke Scale (NIHSS), 9-Hole-Peg as well as patient reported outcomes (via Stroke Impact Scale) were collected during the same research visits. Results: In a total sample of N = 19 patients with upper extremity weakness after stroke who performed Hevelius testing, the median age was 66 (range 47 - 81) with 70% male participants. Nine participants had strokes affecting their dominant arm. LASSO method was used for regression to simultaneously performs feature selection and fitting of a linear model. Score estimates on Hevelius platform correlated strongly on linear regression modeling with clinical scores (from r=0.675 for arm portion of NIHSS ). There was also correlation with 9-Hole-Peg (r=0.581) and no clear correlation with UE-FM, modified Rankin score and Stroke Impact Scale. Five of the 9 patients with dominant arm affected by stroke had NIHSS of 0 and UE-FM of 66. Abnormal movement kinematics were detected in both the contralesional and ipsilesional arms when compared to healthy controls. Conclusions: Characteristics of arm movement are essential to the understanding of motor recovery after stroke. Our study demonstrates subtle deficits of arm movement in task-directed testing that were not captured with traditional measures of stroke recovery.

Design a Haptic-Combined Virtual Reality System to Improve Box and Block Test (BBT) for Upper Extremity Function Assessment

2020 ◽  
Author(s):  
Ying Dong ◽  
Xiaoyu Liu ◽  
Min Tang ◽  
Hongqiang Huo ◽  
Duo Chen ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Healthy Subjects ◽  
Kinematic Parameters ◽  
Stroke Patients ◽  
Retest Reliability ◽  
Zero Crossings ◽  
Block Test ◽  
Test Retest Reliability ◽  
Function Assessment

Abstract Background: The Box and Block Test (BBT) has been widely used to assess gross upper extremity (UE) motor function. We designed a haptic-combined virtual reality (VR) system, named VBBT, to improve BBT with kinematic parameters for more specific assessments.Methods: According to the block-transfer task in BBT, we designed a VBBT system with a haptic device to provide a sense of the grasping force and block's gravity during task performance for UE function assessment. Besides the number of transferred blocks (N-TB), some kinematic parameters were also collected in VBBT for more specific assessment, including the number of zero-crossings of moving acceleration (NZC-ACC), the number of zero-crossings of derivative of releasing force (NZC-DRF), the ratio of path length and linear length (PLR) and the distance between barrier partition and drop position (DDP). 16 post-stroke patients and 113 healthy subjects were recruited to examine quantitative performances, concurrent validity, test-retest reliability and subjective preference between the BBT and VBBT.Results: Based on the measurements of 95% healthy subjects, the normative ranges of quantitative performances were established for BBT and VBBT. Deficiencies in patients’ UE function could be identified when their measurements fell outsides. A moderate correlation was found in the N-TBs between the VBBT and BBT (r = 0.42). The measurements in VBBT presented a stronger age-related correlation than that in BBT (R2 = 0.57 and R2 = 0.16). The N-TBs in both BBT and VBBT were strongly correlated to the Action Research Arm Test (ARAT) (|r| = 0.84 and 0.83), and the NZC-ACC and NZC-DRF in VBBT also showed significant correlations. (|r| = 0.76 and 0.79). The N-TB, NZC-ACC and NZC-DRF in VBBT showed a good test-retest reliability (ICC = 0.75, 0.78 and 0.80) while a moderate reliability was found in BBT (ICC = 0.62). For the patient preference, VBBT was given a higher score than the BBT (p < 0.05) for its enjoyment and completion effort performing.Conclusion: The VBBT improved a gross manual assessment in BBT, which can provide clinically validated, reliable and motivative assessment with kinematic parameters for specific UE motor functions of post-stroke patients.

scholarly journals Kinematic parameters obtained with the ArmeoSpring for upper-limb assessment after stroke: a reliability and learning effect study for guiding parameter use

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Nabila Brihmat ◽  
Isabelle Loubinoux ◽  
Evelyne Castel-Lacanal ◽  
Philippe Marque ◽  
David Gasq
Keyword(s):  
Upper Extremity ◽  
Repeated Measures ◽  
Learning Effect ◽  
Assessment Tool ◽  
Peak Velocity ◽  
Minimal Detectable Change ◽  
Kinematic Parameters ◽  
Stroke Patients ◽  
Post Stroke ◽  
Significant Difference

Abstract Background After stroke, kinematic measures obtained with non-robotic and robotic devices are highly recommended to precisely quantify the sensorimotor impairments of the upper-extremity and select the most relevant therapeutic strategies. Although the ArmeoSpring exoskeleton has demonstrated its effectiveness in stroke motor rehabilitation, its interest as an assessment tool has not been sufficiently documented. The aim of this study was to investigate the psychometric properties of selected kinematic parameters obtained with the ArmeoSpring in post-stroke patients. Methods This study involved 30 post-stroke patients (mean age = 54.5 ± 16.4 years; time post-stroke = 14.7 ± 26.7 weeks; Upper-Extremity Fugl-Meyer Score (UE-FMS) = 40.7 ± 14.5/66) who participated in 3 assessment sessions, each consisting of 10 repetitions of the ‘horizontal catch’ exercise. Five kinematic parameters (task and movement time, hand path ratio, peak velocity, number of peak velocity) and a global Score were computed from raw ArmeoSpring’ data. Learning effect and retention were analyzed using a 2-way repeated-measures ANOVA, and reliability was investigated using the intra-class correlation coefficient (ICC) and minimal detectable change (MDC). Results We observed significant inter- and intra-session learning effects for most parameters except peak velocity. The measures performed in sessions 2 and 3 were significantly different from those of session 1. No additional significant difference was observed after the first 6 trials of each session and successful retention was also highlighted for all the parameters. Relative reliability was moderate to excellent for all the parameters, and MDC values expressed in percentage ranged from 42.6 to 102.8%. Conclusions After a familiarization session, the ArmeoSpring can be used to reliably and sensitively assess motor impairment and intervention effects on motor learning processes after a stroke. Trial registration The study was approved by the local hospital ethics committee in September 2016 and was registered under number 05-0916.

scholarly journals Predicting Recovery of Voluntary Upper Extremity Movement in Subacute Stroke Patients with Severe Upper Extremity Paresis

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0126857 ◽  
Author(s):  
Chia-Lin Koh ◽  
Shin-Liang Pan ◽  
Jiann-Shing Jeng ◽  
Bang-Bin Chen ◽  
Yen-Ho Wang ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Stroke Patients ◽  
Subacute Stroke ◽  
Upper Extremity Movement

scholarly journals Bilateral actigraphic quantification of upper extremity movement in hemiparetic children with perinatal stroke: a case control study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Asha Hollis ◽  
Lauran Cole ◽  
Ephrem Zewdie ◽  
Megan J. Metzler ◽  
Adam Kirton
Keyword(s):  
Upper Extremity ◽  
Real Life ◽  
Arm Movement ◽  
Asymmetry Index ◽  
Movement Asymmetry ◽  
Block Test ◽  
Motor Outcomes ◽  
And Control ◽  
Upper Extremity Movement ◽  
Standard Tests

Abstract Background Hemiparetic cerebral palsy impacts millions of people worldwide. Assessment of bilateral motor function in real life remains a major challenge. We evaluated quantification of upper extremity movement in hemiparetic children using bilateral actigraphy. We hypothesized that movement asymmetry correlates with standard motor outcome measures. Methods Hemiparetic and control participants wore bilateral wrist Actiwatch2 (Philips) for 48 h with movement counts recorded in 15-s intervals. The primary outcome was a novel statistic of movement asymmetry, the Actigraphic Movement Asymmetry Index (AMAI). Relationships between AMAI and standard motor outcomes (Assisting Hand Assessment, Melbourne Assessment, and Box and Block Test [BB]) were explored with Pearson or Spearman correlation. Results 30 stroke (mean 11 years 2 months (3 years 10 months); 13 female, 17 male) and 23 control (mean 11 years 1 month (4 years 5 months); 8 female, 15 male) were enrolled. Stroke participants demonstrated higher asymmetry. Correlations between AMAI and standard tests were moderate and strongest during sleep (BB: r = 0.68, p < 0.01). Conclusions Standard tests may not reflect the extent of movement asymmetry during daily life in hemiparetic children. Bilateral actigraphy may be a valuable complementary tool for measuring arm movement, potentially enabling improved evaluation of therapies with a focus on child participation.

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