To examine the validity of 5 robot-based assessments of arm motor function post-stroke.
Outpatient clinical research center.
Volunteer sample of 40 participants, age >18 years, 3-6 months post-stroke, with arm motor deficits that had plateaued.
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 .
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.
The current findings support using a battery of robot-based methods for assessing the upper extremity motor function in subjects with chronic stroke.
McKenzie A, Dodakian L, See J, Le V, Quinlan EB, Bridgford C, Head D, Han VL, Cramer SC, Validity of Robot-based Assessments of Upper Extremity Function, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2017), doi: 10.1016/j.apmr.2017.02.033.
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