Optimizing Stroke Detection Using Evidential Networks and Uncertainty-Based Refinement

IEEE Transactions on Neural Systems and Rehabilitation Engineering, Journal Year: 2025, Volume and Issue: 33, P. 566 - 576

Published: Jan. 1, 2025

Evaluating neurological impairments post-stroke is essential for assessing treatment efficacy and managing subsequent disabilities. Conventional clinical assessment methods depend largely on clinicians' visual physical evaluations, resulting in coarse rating systems that frequently miss subtle or improvements. Interactive robotic devices, like the Kinarm Exoskeleton system, are transforming of motor by offering precise objective movement measurements. In this study, we analyzed kinematic data from 337 stroke patients 368 healthy controls performing three tasks. Using deep learning methods, particularly an evidential network, distinguished impaired participants while generating measures prediction uncertainty. By retraining network with least uncertain samples refining test set excluding top 10% most samples, improved sensitivity detecting minimally (those scoring normal CMSA) 0.55 to 0.75. We further extended model detect associated transient ischemic attack (TIA), increased detection accuracy 0.86 0.92. The model's ability identify deficits, even TIA who show no observable symptoms standard exams, highlights its significant utility. Detecting critical, as individuals experience a have substantially higher risk recurrent stroke. This work immense potential integrating uncertainty estimation enhance stroke-related impairments, potentially paving way personalized rehabilitation.

Language: Английский

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Exploring the Link Between Motor Functions and the Relative Use of the More Affected Arm in Adults with Cerebral Palsy

Sensors, Journal Year: 2025, Volume and Issue: 25(3), P. 660 - 660

Published: Jan. 23, 2025

Individuals with hemiparetic cerebral palsy (CP) exhibit reduced use of their more affected (MA) arm, yet the factors that influence its during activities daily living remain elusive. The objectives this study were to describe relative MA arm an ecological task, examine relationship level impairment, and investigate association performance in various unilateral bilateral tasks. Methods: Participants took part two sessions comprising robotic assessments clinical motor functions, as well accelerometry measurement kitchen Four variables derived from data. Stepwise regression analyses used identify best contributors among assessments. Results: Nineteen adults CP (34.3 years old ± 11.5; MACS I = 7, II 6, III 6) included. Use Ratio measured tasks ranged between 0.10 0.63. predictors all metrics (r2 0.23–0.64). Conclusions: importance assessing was reaffirmed by key role played determining arm. results support intensity-based measure use.

Language: Английский

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Robotic assessment of sensorimotor and cognitive deficits in patients with temporal lobe epilepsy

Epilepsy & Behavior, Journal Year: 2024, Volume and Issue: 151, P. 109613 - 109613

Published: Jan. 5, 2024

Individuals with temporal lobe epilepsy (TLE) frequently demonstrate impairments in executive function, working memory, and/or declarative memory. It is recommended that screening for cognitive impairment undertaken all people newly diagnosed epilepsy. However, standard neuropsychological assessments are a limited resource and thus not available to all. Our study investigated the use of robotic technology (the Kinarm robot) screening.

Language: Английский

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Clinical, Neuroimaging and Robotic Measures Predict Long-Term Proprioceptive Impairments following Stroke

Brain Sciences, Journal Year: 2023, Volume and Issue: 13(6), P. 953 - 953

Published: June 15, 2023

Proprioceptive impairments occur in ~50% of stroke survivors, with 20-40% still impaired six months post-stroke. Early identification those likely to have persistent is key personalizing rehabilitation strategies and reducing long-term proprioceptive impairments. In this study, clinical, neuroimaging robotic measures were used predict at post-stroke on a assessment proprioception. Clinical assessments, neuroimaging, arm position matching (APM) task performed for 133 participants two weeks (12.4 ± 8.4 days). The APM was also (191.2 18.0 Robotics allow more precise measurements proprioception than clinical assessments. Consequently, an overall Task Score as ground truth classify Other performance parameters from the two-week predictive features. assessments included Thumb Localisation Test (TLT), Behavioural Inattention (BIT), Functional Independence Measure (FIM) demographic information (age, sex affected arm). Logistic regression classifiers trained using data collected Models containing features, either alone or conjunction had greater area under curve (AUC) lower Akaike Information Criterion (AIC) models which only contained All similarly regard accuracy F1-score (>70% accuracy). Robotic features among most important when all combined into single model. Predicting impairments, early post-stroke, feasible. Identifying risk step towards improving after stroke.

Language: Английский

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Resting state functional connectivity associated with impaired proprioception post‐stroke

Human Brain Mapping, Journal Year: 2023, Volume and Issue: 45(1)

Published: Dec. 5, 2023

Abstract Deficits in proprioception, the knowledge of limb position and movement absence vision, occur ~50% all strokes; however, our lack neurological mechanisms these deficits diminishes effectiveness rehabilitation prolongs recovery. We performed resting‐state functional magnetic resonance imaging (fMRI) on stroke patients to determine brain networks that exhibited changes connectivity association with proprioception determined by a Kinarm robotic exoskeleton assessment. Thirty participants were assessed for proprioceptive impairments using robot underwent fMRI at 1 month post‐stroke. Age‐matched healthy control ( n = 30) data also examined compared terms regions associated proprioception. Stroke reduced supplementary motor area supramarginal gyrus, relative controls. Functional plus primary somatosensory cortex parietal opercular was significantly function. The lobe lesioned hemisphere is significant node after stroke. Assessment this region may assist prognostication This study provides potential targets therapeutic neurostimulation aid

Language: Английский

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A robot-based interception task to quantify upper limb impairments in proprioceptive and visual feedback after stroke

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2023, Volume and Issue: 20(1)

Published: Oct. 11, 2023

A key motor skill is the ability to rapidly interact with our dynamic environment. Humans can generate goal-directed actions in response sensory stimulus within ~ 60-200ms. This be impaired after stroke, but most clinical tools lack any measures of rapid feedback processing. Reaching tasks have been used as a framework quantify impairments generating corrections for individuals stroke. However, reaching may inadequate an assessment tool repeated fatiguing Further, requires many trials completed including and without disturbances, thus, exacerbate fatigue. Here, we describe novel robotic task processing healthy controls compare this performance stroke (more) efficiently identify processing.We assessed cohort (n = 135) 40; Mean 41 days from stroke) Fast Feedback Interception Task (FFIT) using Kinarm Exoskeleton robot. Participants were instructed intercept circular white target moving towards them their hand represented virtual paddle. On some trials, arm could physically perturbed, or paddle abruptly change location, colour requiring individual now avoid target.Most participants reaction time (85%) end-point accuracy (83%) at least one conditions, commonly shifts. Of note, impairment was also evident when performing unaffected (75%). Comparison upper limb identified moderate correlations FFIT.The FFIT able high proportion either affected arms. The allows different types responses short amount time.

Language: Английский

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Calibration of Impairment Severity to Enable Comparison across Somatosensory Domains

Brain Sciences, Journal Year: 2023, Volume and Issue: 13(4), P. 654 - 654

Published: April 13, 2023

Comparison across somatosensory domains, important for clinical and scientific goals, requires prior calibration of impairment severity. Provided test score distributions are comparable valid comparisons can be made by reference to locations in the corresponding (percentile rank or standardized scores). However, this is often not case. Test tactile texture discrimination (n = 174), wrist joint proprioception 112), haptic object identification 98) obtained from pooled samples stroke survivors rehabilitation settings were investigated. The showed substantially different forms, undermining comparative via percentile scores. An alternative approach establish psychophysical ranges spanning performance just noticeably impaired maximally impaired. Several simulation studies a theoretical analysis conducted expected completely insensate responders each domain. Estimates extreme values suggested theory, observed consistent. Using these estimates previously discovered thresholds domain, noticeable found. These enable normalization three scales comparison research settings.

Language: Английский

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A pilot study for self-guided, active robotic training of proprioception of the upper limb in chronic stroke

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: June 7, 2024

Background Proprioceptive impairments of the upper limb are common after stroke. These not typically addressed during assessment or rehabilitation. Currently, most robotic paradigms for rehabilitative training have focused solely on improving motor function targeted proprioception in individuals with combined use visual feedback. Our goal was to design a paradigm that directly targets limb, while minimizing reliance other sensory information improve sensorimotor Methods In this pilot study, 5 stroke participants and age-matched controls were tested single-day proprioceptive paradigm. Here, used joystick their less-affected arm send commands KINARM exoskeleton would passively move more-affected arm. To complete passive reaching task, relied only feedback from given knowledge results each trial. Sensorimotor measured pre- post-training via measures (Visually Guided Reaching (VGR)) position sense (Arm Position Matching (APM)). quantified as Task Score, which incorporated multiple task-relevant parameters both VGR APM. Changes performance due calculated difference APM within control groups. Results We found significant improvements pre-training (p < 0.001, CLES = 100) observed 0.87, 80). changes (Posture Speed, Reaction Time, Initial Direction Angle, Min-Max Speed Difference, Movement Time) (Contraction/Expansion Ratio_x Shift_y) parameters. Conclusions novel resulted aspects chronic This study demonstrates feasibility Future studies aim examine multi-day longer-term impacts function.

Language: Английский

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Proportional Recovery After Stroke: Addressing Concerns Regarding Mathematical Coupling and Ceiling Effects

Neurorehabilitation and neural repair, Journal Year: 2023, Volume and Issue: 37(7), P. 488 - 498

Published: June 2, 2023

Baseline scores after stroke have long been known as a good predictor of post-stroke outcomes. Similarly, the extent baseline impairment has shown to strongly correlate with spontaneous recovery in first 3 6 months stroke, principle proportional recovery. However, recent critiques proposed that is confounded, most notably by mathematical coupling and ceiling effects, it may not be valid model for This article reviews current understanding discusses its supposed confounds comments on validity usefulness We demonstrate true measurement value real statistical confound, but rather notational construct no effect correlation itself. On other hand, does apply error can spuriously amplify sizes, should negligible cases. also explain compression toward corresponding relationship are consistent our dynamics, than being unwanted confounds. while valid, particularly groundbreaking or meaningful previously thought, just like how correlations between outcomes relatively common research. Whether through baseline-outcome regression, starting point investigating factors determine stroke.

Language: Английский

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Directional and general impairments in initiating motor responses after stroke

Brain Communications, Journal Year: 2023, Volume and Issue: 5(2)

Published: March 2, 2023

Visuospatial neglect is a disorder characterized by an impairment of attention, most commonly to the left side space in individuals with stroke or injury right hemisphere. Clinical diagnosis largely based on performance pen and paper examinations that are unable accurately measure speed processing environmental stimuli-important for interacting our dynamic world. Numerous studies after visuospatial demonstrate delayed reaction times when reaching left. However, little known other spatial directions and, further, influence arm being assessed. In this study, we quantify ability large cohort 204 healthy control participants (females = 102) 265 (right hemisphere damage 162, 103; mean age 62) generate goal-directed reaches. Participants used both their contralesional ipsilesional arms perform centre-out visually guided task horizontal plane. We found range can vary dramatically across some displaying time impairments restricted relatively small portion workspace, whereas others displayed all directions. Reaction were observed lesions (48% 30%, respectively). Directional rotated clockwise versus arms. Impairment was more prevalent than (32% 12%, Behavioral Inattention Test scores significantly correlated (r -0.49, P < 0.005) but not identified as having still (35%). MRI CT scans distinct white matter cortical regions directional (insula, inferior frontal-occipital fasciculus longitudinal fasciculus) general (superior middle temporal gyri) impairment. This study highlights prevalence diversity occur following stroke.

Language: Английский

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