Chien-Hung Yeh1, Chi-Yao Hung2, Yung-Hung Wang3, Wei-Tai Hsu3, Yi-Chung Chang4, Jia-Rong Yeh3, Po-Lei Lee5, Kun Hu6, Jiunn-Horng Kang7, Men-Tzung Lo8. 1. Department of Electrical Engineering, National Central University, Taoyuan City 32001, Taiwan; Research Center for Adaptive Data Analysis, National Central University, Taoyuan City 32001, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taoyuan City 32001, Taiwan; Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA. 2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei Medical University, Taipei 110, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan. 3. Research Center for Adaptive Data Analysis, National Central University, Taoyuan City 32001, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taoyuan City 32001, Taiwan. 4. Research Center for Adaptive Data Analysis, National Central University, Taoyuan City 32001, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taoyuan City 32001, Taiwan; Graduate Institute of Communication Engineering, National Taiwan University, Taipei 10617, Taiwan. 5. Department of Electrical Engineering, National Central University, Taoyuan City 32001, Taiwan; Research Center for Adaptive Data Analysis, National Central University, Taoyuan City 32001, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taoyuan City 32001, Taiwan. 6. Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA. 7. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei Medical University, Taipei 110, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan. Electronic address: kang.jiunnhorng@gmail.com. 8. Research Center for Adaptive Data Analysis, National Central University, Taoyuan City 32001, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taoyuan City 32001, Taiwan; Institute of Translational and Interdisciplinary Medicine and Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City 32001, Taiwan. Electronic address: mzlo@ncu.edu.tw.
Abstract
BACKGROUND: The pendulum test is a standard clinical test for quantifying the severity of spasticity. In the test, an electrogoniometer is typically used to measure the knee angular motion. The device is costly and difficult to set up such that the pendulum test is normally time consuming. OBJECTIVE: The goal of this study is to determine whether a Nintendo Wii remote can replace the electrogroniometer for reliable assessment of the angular motion of the knee in the pendulum test. METHODS: The pendulum test was performed in three control participants and 13 hemiplegic stroke patients using both a Wii remote and an electrogoniometer. The correlation coefficient and the Bland-Altman difference plot were used to compare the results obtained from the two devices. The Wilcoxon signed-rank test was used to compare the difference between hemiplegia-affected and nonaffected sides in the hemiplegic stroke patients. RESULTS: There was a fair to strong correlation between measurements from the Wii remote and the electrogoniometer (0.513<R(2)<0.800). Small but consistent differences between the Wii remote and electrogoniometer were identified from the Bland-Altman difference plot. Within the hemiplegic stroke patients, both devices successfully distinguished the hemiplegia-affected (spastic) side from the nonaffected (nonspastic) side (both with p<.0001*). In addition, the intraclass correlation coefficient, standard error of measurement, and minimum detectable differences were highly consistent for both devices. CONCLUSION: Our findings suggest that the Wii remote may serve as a convenient and cost-efficient tool for the assessment of spasticity.
BACKGROUND: The pendulum test is a standard clinical test for quantifying the severity of spasticity. In the test, an electrogoniometer is typically used to measure the knee angular motion. The device is costly and difficult to set up such that the pendulum test is normally time consuming. OBJECTIVE: The goal of this study is to determine whether a Nintendo Wii remote can replace the electrogroniometer for reliable assessment of the angular motion of the knee in the pendulum test. METHODS: The pendulum test was performed in three control participants and 13 hemiplegic strokepatients using both a Wii remote and an electrogoniometer. The correlation coefficient and the Bland-Altman difference plot were used to compare the results obtained from the two devices. The Wilcoxon signed-rank test was used to compare the difference between hemiplegia-affected and nonaffected sides in the hemiplegic strokepatients. RESULTS: There was a fair to strong correlation between measurements from the Wii remote and the electrogoniometer (0.513<R(2)<0.800). Small but consistent differences between the Wii remote and electrogoniometer were identified from the Bland-Altman difference plot. Within the hemiplegic strokepatients, both devices successfully distinguished the hemiplegia-affected (spastic) side from the nonaffected (nonspastic) side (both with p<.0001*). In addition, the intraclass correlation coefficient, standard error of measurement, and minimum detectable differences were highly consistent for both devices. CONCLUSION: Our findings suggest that the Wii remote may serve as a convenient and cost-efficient tool for the assessment of spasticity.
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