BACKGROUND: Impairment of position sense of the upper extremity (UE) may impede activities of daily living and limit motor gains after stroke. Most clinical assessments of position sense rely on categorical or ordinal ratings by clinicians that lack sensitivity to change or the ability to discriminate subtle deficits. OBJECTIVE: Use robotic technology to develop a reliable, quantitative technique with a continuous scale to assess UE position sense following stroke. METHODS: Forty-five patients recruited from an inpatient stroke rehabilitation service and 65 age-matched healthy controls performed an arm position matching task. Each UE was fitted in the exoskeleton of a KINARM device. One UE was passively placed in one of 9 positions, and the subject was told to match his or her position with the other UE. Patients were compared with statistical distributions of control data to identify those with deficits in UE position sense. Test-retest sessions using 2 raters established interrater reliability. RESULTS: Two thirds of left hemiparetic and one third of right hemiparetic patients had deficits in limb position sense. Left-affected stroke subjects demonstrated significantly more trial-to-trial variability than right-affected or control subjects. The robotic assessment technique demonstrated good interrater reliability but limited agreement with the clinical thumb localizing test. CONCLUSIONS: Robotic technology can provide a reliable quantitative means to assess deficits in limb position sense following stroke.
BACKGROUND: Impairment of position sense of the upper extremity (UE) may impede activities of daily living and limit motor gains after stroke. Most clinical assessments of position sense rely on categorical or ordinal ratings by clinicians that lack sensitivity to change or the ability to discriminate subtle deficits. OBJECTIVE: Use robotic technology to develop a reliable, quantitative technique with a continuous scale to assess UE position sense following stroke. METHODS: Forty-five patients recruited from an inpatient stroke rehabilitation service and 65 age-matched healthy controls performed an arm position matching task. Each UE was fitted in the exoskeleton of a KINARM device. One UE was passively placed in one of 9 positions, and the subject was told to match his or her position with the other UE. Patients were compared with statistical distributions of control data to identify those with deficits in UE position sense. Test-retest sessions using 2 raters established interrater reliability. RESULTS: Two thirds of left hemiparetic and one third of right hemipareticpatients had deficits in limb position sense. Left-affected stroke subjects demonstrated significantly more trial-to-trial variability than right-affected or control subjects. The robotic assessment technique demonstrated good interrater reliability but limited agreement with the clinical thumb localizing test. CONCLUSIONS: Robotic technology can provide a reliable quantitative means to assess deficits in limb position sense following stroke.
Authors: Ann Van de Winckel; Nicole Wenderoth; Willy De Weerdt; Stefan Sunaert; Ron Peeters; Wim Van Hecke; Vincent Thijs; Stephan P Swinnen; Carlo Perfetti; Hilde Feys Journal: Exp Brain Res Date: 2012-05-31 Impact factor: 1.972
Authors: Ronen Blecher; Lia Heinemann-Yerushalmi; Eran Assaraf; Nitzan Konstantin; Jens R Chapman; Timothy C Cope; Guy S Bewick; Robert W Banks; Elazar Zelzer Journal: Philos Trans R Soc Lond B Biol Sci Date: 2018-09-24 Impact factor: 6.237
Authors: Jacey L Janz Vernoski; Jack R Bjorkland; Talia J Kramer; Steven T Oczak; Alexandra L Borstad Journal: J Vis Exp Date: 2018-03-03 Impact factor: 1.355