Document Type

Article

Publication Date

5-5-2017

Abstract

Objective

To examine the validity of 5 robot-based assessments of arm motor function post-stroke.

Design

Cross sectional.

Setting

Outpatient clinical research center.

Participants

Volunteer sample of 40 participants, age >18 years, 3-6 months post-stroke, with arm motor deficits that had plateaued.

Intervention

None.

Main Outcome Measures

Clinical standards included the Fugl-Meyer Arm

Motor Scale (FMA), and 5 secondary motor outcomes: hand/wrist subsection of the FMA; Action Research Arm Test (ART); Box & Blocks test (B/B); hand subscale of Stroke Impact Scale-2 (SIS); and the Barthel Index (BI). Robot-based assessments included: wrist targeting; finger targeting; finger movement speed; reaction time; and a robotic version of the (B/B) test. Anatomical measures included percentage injury to the corticospinal tract (CST) and primary motor cortex (M1, hand region) obtained from MRI .

Results

Subjects had moderate-severe impairment (arm FMA scores = 35.6±14.4, range 13.5-60). Performance on the robot-based tests, including speed (r=0.82, p<0.0001), wrist targeting (r=0.72, p<0.0001), and finger targeting (r=0.67, p<0.0001) correlated significantly with the FMA scores. Wrist targeting (r=0.57 - 0.82) and finger targeting (r=0.49 - 0.68) correlated significantly with all 5 secondary motor outcomes and with percent CST injury. The robotic version of the B/B correlated significantly with the clinical B/B test but was less prone to floor effect. Robot-based assessments were comparable to FMA score in relation to percent CST injury and superior in relation to M1 hand injury.

Conclusions

The current findings support using a battery of robot-based methods for assessing the upper extremity motor function in subjects with chronic stroke.

Comments

NOTICE: this is the author’s version of a work that was accepted for publication in Archives of Physical Medicine and Rehabilitation. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version will be subsequently published in Archives of Physical Medicine and Rehabilitation in 2017. DOI:

The Creative Commons license below applies only to this version of the article.

Peer Reviewed

1

Copyright

Elsevier

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Available for download on Saturday, May 05, 2018

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