Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke.
Background: Neurological injuries such as stroke often differentially impair hand motor and somatosensory function, as well as the interplay between the two, which leads to limitations in performing activities of daily living. However, it is challenging to identify which specific aspects of sensorim...
| Publicado en: | Journal of NeuroEngineering & Rehabilitation (JNER) Vol. 18; no. 1; pp. 1 - 21 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
7/16/2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151437768&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151437768 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17430003 1CUC jtl: Journal of NeuroEngineering & Rehabilitation (JNER) issn: 17430003 maglogo: N pubinfo: dt: 7/16/2021 vid: 18 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 151437768 151437768 NLM34271954 151437768 10.1186/s12984-021-00904-5 NLM34271954 151437768 ppf: 1 ppct: 20 formats: tig: atl: Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke. aug: au: Zbytniewska, Monika Kanzler, Christoph M. Jordan, Lisa Salzmann, Christian Liepert, Joachim Lambercy, Olivier Gassert, Roger affil: Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland sug: subj: Stroke Complications Robotics Human Upper Extremity Reproducibility of Results Hand Activities of Daily Living Comparative Studies Multicenter Studies Evaluation Research Validation Studies Clinical Assessment Tools ab: Background: Neurological injuries such as stroke often differentially impair hand motor and somatosensory function, as well as the interplay between the two, which leads to limitations in performing activities of daily living. However, it is challenging to identify which specific aspects of sensorimotor function are impaired based on conventional clinical assessments that are often insensitive and subjective. In this work we propose and validate a set of robot-assisted assessments aiming at disentangling hand proprioceptive from motor impairments, and capturing their interrelation (sensorimotor impairments).Methods: A battery of five complementary assessment tasks was implemented on a one degree-of-freedom end-effector robotic platform acting on the index finger metacarpophalangeal joint. Specifically, proprioceptive impairments were assessed using a position matching paradigm. Fast target reaching, range of motion and maximum fingertip force tasks characterized motor function deficits. Finally, sensorimotor impairments were assessed using a dexterous trajectory following task. Clinical feasibility (duration), reliability (intra-class correlation coefficient ICC, smallest real difference SRD) and validity (Kruskal-Wallis test, Spearman correlations [Formula: see text] with Fugl-Meyer Upper Limb Motor Assessment, kinesthetic Up-Down Test, Box & Block Test) of robotic tasks were evaluated with 36 sub-acute stroke subjects and 31 age-matched neurologically intact controls.Results: Eighty-three percent of stroke survivors with varied impairment severity (mild to severe) could complete all robotic tasks (duration: <15 min per tested hand). Further, the study demonstrated good to excellent reliability of the robotic tasks in the stroke population (ICC>0.7, SRD<30%), as well as discriminant validity, as indicated by significant differences (p-value<0.001) between stroke and control subjects. Concurrent validity was shown through moderate to strong correlations ([Formula: see text]=0.4-0.8) between robotic outcome measures and clinical scales. Finally, robotic tasks targeting different deficits (motor, sensory) were not strongly correlated with each other ([Formula: see text]0.32, p-value>0.1), thereby presenting complementary information about a patient's impairment profile.Conclusions: The proposed robot-assisted assessments provide a clinically feasible, reliable, and valid approach to distinctly characterize impairments in hand proprioceptive and motor function, along with the interaction between the two. This opens new avenues to help unravel the contributions of unique aspects of sensorimotor function in post-stroke recovery, as well as to contribute to future developments towards personalized, assessment-driven therapies. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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