Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals
Author:
Kanzler Christoph M.ORCID, Schwarz Anne, Held Jeremia P.O., Luft Andreas R.ORCID, Gassert RogerORCID, Lambercy OlivierORCID
Abstract
AbstractBackgroundAssessing 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 established kinematic and kinetic core metrics were extracted and compared to conventional clinical scales of impairment and activity limitations. Additionally, the robustness of the VPIT metrics was investigated by analyzing their clinimetric properties (test-retest reliability, measurement error, and learning effects).ResultsTwenty-three of the participants, the ones with mild to moderate sensorimotor impairments and without strong cognitive deficits, were able to successfully complete the VPIT protocol (duration 16.6 min). The VPIT metrics detected impairments in arm and hand in 90.0% of the participants, and were sensitive to increased muscle tone and pathological joint coupling. Most importantly, moderate to high significant correlations between conventional scales of activity limitations and the VPIT metrics were found, thereby indicating their functional relevance when grasping and transporting lightweight objects as well as dexterous finger manipulations. Lastly, the robustness of three out of the ten VPIT core metrics in post-stroke individuals was confirmed.ConclusionsThis work provides evidence that technology-aided assessments requiring goal-directed manipulations without arm weight support can provide an objective, robust, and clinically feasible way to assess functionally relevant sensorimotor impairments in arm and hand in chronic post-stroke individuals with mild to moderate deficits. This allows better identifying impairments with high functional relevance and can contribute to optimizing the functional benefits of neurorehabilitation interventions.Retrospectively registered: clinicaltrials.gov/ct2/show/NCT03135093
Publisher
Cold Spring Harbor Laboratory
Reference80 articles.
1. Emelia J. Benjamin , Paul Muntner , Alvaro Alonso , Marcio S. Bittencourt , Clifton W. Callaway , April P. Carson , Alanna M. Chamberlain , Alexander R. Chang , Susan Cheng , Sandeep R. Das , Francesca N. Delling , Luc Djousse, Mitchell S.V. Elkind , Jane F. Ferguson , Myriam Fornage , Lori Chaffin Jordan , Sadiya S. Khan , Brett M. Kissela , Kristen L. Knutson , Tak W. Kwan , Daniel T. Lackland , Tené T. Lewis , Judith H. Lichtman , Chris T. Longenecker , Matthew Shane Loop , Pamela L. Lutsey , Seth S. Martin , Kunihiro Matsushita , Andrew E. Moran , Michael E. Mussolino , Martin O’Flaherty , Ambarish Pandey , Amanda M. Perak , Wayne D. Rosamond , Gregory A. Roth , Uchechukwu K. A. Sampson , Gary M. Satou , Emily B. Schroeder , Svati H. Shah , Nicole L. Spartano , Andrew Stokes , David L. Tirschwell , Connie W. Tsao , Mintu P. Turakhia , Lisa B. VanWagner , John T. Wilkins , Sally S. Wong , and Salim S. Virani . Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association, volume 10. American Heart Association, 2019. 2. Estimates of the Prevalence of Acute Stroke Impairments and Disability in a Multiethnic Population 3. World Health Organization. International classification of functioning, disability and health: ICF. World Health Organization, 2001. 4. Alex Pollock , Sybil E Farmer , Marian C Brady , Peter Langhorne , Gillian E Mead , Jan Mehrholz , and Frederike van Wijck . Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews, (11), nov 2014. 5. Beverley French , Lois H Thomas , Jacqueline Coupe , Naoimh E McMahon , Louise Connell , Joanna Harrison , Christopher J Sutton , Svetlana Tishkovskaya , and Caroline L Watkins . Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews, (11), nov 2016.
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