Literature review of stroke assessment for upper-extremity physical function via EEG, EMG, kinematic, and kinetic measurements and their reliability

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

Published: Feb. 15, 2023

Significant clinician training is required to mitigate the subjective nature and achieve useful reliability between measurement occasions therapists. Previous research supports that robotic instruments can improve quantitative biomechanical assessments of upper limb, offering reliable more sensitive measures. Furthermore, combining kinematic kinetic measurements with electrophysiological offers new insights unlock targeted impairment-specific therapy. This review presents common methods for analyzing neuromuscular data by describing their validity reporting measures.This paper reviews literature (2000-2021) on sensor-based measures metrics upper-limb (neurological) assessment, which have been shown correlate clinical test outcomes motor assessment. The search terms passive devices developed movement Journal conference papers stroke assessment were selected using PRISMA guidelines. Intra-class correlation values some are recorded, along model, type agreement, confidence intervals, when reported.A total 60 articles identified. assess various aspects performance, such as smoothness, spasticity, efficiency, planning, efficacy, accuracy, coordination, range motion, strength. Additional abnormal activation patterns cortical activity interconnections brain regions muscle groups; aiming characterize differences population who had a healthy population.Range mean speed, distance, normal path length, spectral arc number peaks, task time all demonstrated good excellent reliability, well provide finer resolution compared discrete tests. EEG power features multiple frequency bands interest, specifically relating slow fast frequencies comparing affected non-affected hemispheres, demonstrate populations at stages recovery. Further investigation needed evaluate missing information. In few studies neuroelectric signals, multi-domain approaches agreement further information during relearning phase. Combining in process will objective approach, relying less therapist expertise. suggests future work prevent biasedness selecting appropriate analysis.

Language: Английский

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Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2021, Volume and Issue: 18(1)

Published: July 16, 2021

Abstract Background Neurological injuries such as stroke often differentially impair hand motor and somatosensory function, well the interplay between two, which leads to limitations in performing activities of daily living. However, it is challenging identify specific aspects sensorimotor function are impaired based on conventional clinical assessments that insensitive subjective. In this work we propose validate a set robot-assisted aiming at disentangling proprioceptive from impairments, capturing their interrelation (sensorimotor impairments). Methods A battery five complementary assessment tasks was implemented one degree-of-freedom end-effector robotic platform acting index finger metacarpophalangeal joint. Specifically, impairments were assessed using position matching paradigm. Fast target reaching, range motion maximum fingertip force characterized deficits. Finally, dexterous trajectory following task. Clinical feasibility (duration), reliability (intra-class correlation coefficient ICC, smallest real difference SRD) validity (Kruskal-Wallis test, Spearman correlations $$\rho$$ ρ with Fugl-Meyer Upper Limb Motor Assessment, kinesthetic Up-Down Test, Box & Block Test) evaluated 36 sub-acute subjects 31 age-matched neurologically intact controls. Results Eighty-three percent survivors varied impairment severity (mild severe) could complete all (duration: <15 min per tested hand). Further, study demonstrated good excellent population (ICC>0.7, SRD<30%), discriminant validity, indicated by significant differences ( p -value<0.001) control subjects. Concurrent shown through moderate strong =0.4-0.8) outcome measures scales. targeting different deficits (motor, sensory) not strongly correlated each other $$\rho \le$$ ≤ 0.32, -value>0.1), thereby presenting information about patient’s profile. Conclusions The proposed provide clinically feasible, reliable, valid approach distinctly characterize along interaction two. This opens new avenues help unravel contributions unique post-stroke recovery, contribute future developments towards personalized, assessment-driven therapies.

Language: Английский

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Assessment of Neurological Impairment and Recovery Using Statistical Models of Neurologically Healthy Behavior

Neurorehabilitation and neural repair, Journal Year: 2022, Volume and Issue: 37(6), P. 394 - 408

Published: Aug. 5, 2022

While many areas of medicine have benefited from the development objective assessment tools and biomarkers, there been comparatively few improvements in techniques used to assess brain function dysfunction. Brain functions such as perception, cognition, motor control are commonly measured using criteria-based, ordinal scales which can be coarse, floor/ceiling effects, often lack precision detect change. There is growing recognition that kinematic kinetic-based measures needed quantify impairments following neurological injury stroke, particular for clinical research trials. This paper will first consider challenges with criteria-based impairment recovery. We then describe how kinematic-based overcome these highlight a statistical approach behavior based on performance neurologically healthy individuals. illustrate this visually-guided reaching task individuals stroke. Finally, has considerable controversy about calculation recovery Here, we our statistical-based provide an effective estimate

Language: Английский

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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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An integrated COgnitive-somatoSensory-MOtor training intervention for upper limb recovery after stroke: Protocol for a Phase II randomized controlled trial

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: March 26, 2025

Background: Up to 85% of stroke survivors experience motor, somatosensory and cognitive deficits. Interventions that simultaneously stimulate functions have the potential maximize processes neuroplasticity optimise upper limb recovery after stroke. This study aims investigate feasibility a personalised integrated COgnitive-somatoSensory-MOtor (iCOSMO) training intervention improve in people with chronic The objectives are: 1) evaluate feasibility, 2) determine preliminary efficacy iCOSMO Methods: The design will be prospective pilot randomised controlled trial two-arms. We aim recruit 40 adults (>6 months). consist combination haptic perception exploratory tasks incorporate active touch movement procedures, robotic using Kinarm Exoskeleton device, focus on motor sensory attributes all tasks. goal-oriented individualised nature severity experimental group receive total 36 hours treatment over 6 weeks. control matched dose Graded Repetitive Arm Supplementary Program home-based exercise programme. Feasibility measures recruitment adherence rates. Robotic assessments conducted standard tasks™. Standardised clinical include Action Research Motor Test Tactile Discrimination Test. Conclusion: This first demonstrate whether it is both feasible beneficial deliver integrating somatosensory, one protocol. may also show individualise It expected arm hand function larger extent than GRASP survivors. proposed help better understand impact combining cognitive, task performance. Trial registration: was prospectively registered Clinicaltrial.gov (NCT06498011) July, 12th, 2024 available at https://clinicaltrials.gov/study/NCT06498011

Language: Английский

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Parkinson's disease participant-led research on the impact of deep brain stimulation frequency

Journal of Parkinson s Disease, Journal Year: 2025, Volume and Issue: unknown

Published: April 11, 2025

Parkinson's disease symptoms, including gait disturbances and speech impairment, substantially impact quality of life. This n-of-1 study examined the effects deep brain stimulation (DBS) frequency on a 54-year-old man with disease. The participant conceived led study, embedding patient insight within project design execution. impacts three DBS frequencies were assessed using markerless motion capture for gait, voice recording analysis, Kinarm robotic tasks upper limb coordination cognitive assessment. found that has clinically significant multiple rigidity, cognitive-motor ability.

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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Robotic assessment of bilateral and unilateral upper limb functions in adults with cerebral palsy

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2024, Volume and Issue: 21(1)

Published: Aug. 22, 2024

Abstract Background Children with unilateral cerebral palsy (CP) exhibit motor impairments predominantly on one side of the body, while also having ipsilesional and bilateral impairments. These are known to persist through adulthood, but their extent have not been described in adults CP. This study’s aim is characterize upper limbs Methods Nineteen CP (34.3 years old ± 11.5) performed three robotic assessments Kinarm Exoskeleton Lab, including two tasks (Object Hit [asymmetric independent goals task] Ball Bar [symmetric common goal task]) task (Visually Guided Reaching, more affected arm [MA] less [LA]). Individual results were compared sex, age handedness matched normative data, describing proportion participants exhibiting each task-specific variable (e.g., Hand speed), performance category Feedforward control) global performance. Associations assessed using Spearman correlation coefficients between: 1: MA LA limb task; 2: vs. tasks. Results The majority exhibited (84%). categories (i.e., Bimanual) identifying coordination impaired Hit: 57.8%; Bar: 31.6%). Most when performing a (63%) smaller (31%). control was showing highest displaying strongest relationship between arms (r s = 0.93). Feedback most often associated (6 out 8 categories). Conclusions Adults experienced impairment still substantial They frequently display combined higher reliance during both tasks, leading poorer

Language: Английский

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Quantitatively assessing aging effects in rapid motor behaviours: a cross-sectional study

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2022, Volume and Issue: 19(1)

Published: July 26, 2022

An individual's rapid motor skills allow them to perform many daily activities and are a hallmark of physical health. Although age sex both known affect performance, standardized methods for assessing their impact on upper limb function limited.Here we cross-sectional study 643 healthy human participants in two interactive tasks developed quantify sensorimotor abilities, Object-Hit (OH) Object-Hit-and-Avoid (OHA). The required hit virtual objects with without the presence distractor objects. Velocities positions hands were recorded by robotic exoskeleton, allowing variety parameters be calculated each trial. We verified that these viable measuring performance humans examined whether any our related or sex.Our analysis shows OH OHA can assess behaviours participants. It also while some decline age, those most associated system do not. Three show significant sex-related effects OH, but disappear OHA.This suggests underlying effect aging is not capabilities system, brain's capacity processing inputs into actions. Additionally, this provides baseline description when using investigate age-related declines ability.

Language: Английский

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Impairments in Cognitive Control Using a Reverse Visually Guided Reaching Task Following Stroke

Neurorehabilitation and neural repair, Journal Year: 2022, Volume and Issue: 36(7), P. 449 - 460

Published: May 16, 2022

Cognitive and motor function must work together quickly seamlessly to allow us interact with a complex world, but their integration is difficult assess directly. Interactive technology provides opportunities actions requiring cognitive control.To adapt reverse reaching task an interactive robotic platform quantify impairments in cognitive-motor following stroke.Participants subacute stroke (N=59) performed two tasks using the Kinarm: Reverse Visually Guided Reaching (RVGR) (VGR). Tasks required subjects move cursor "quickly accurately" virtual targets. In RVGR, motion was reversed compared finger (i.e., hand moves left, right). Task parameters Scores were calculated based on models developed from healthy controls, accounted for influence of age, sex, handedness.Many participants (86%) impaired RVGR affected arm (Task Score > 95% controls). The most common impairment increased movement time. Seventy-three percent also less arm. larger initial direction angles reach. Impairments improved over time, 71% tested longitudinally still ∼6 months post-stroke. Importantly, although 57% at 6 months, these individuals not VGR.Individuals many did show similar standard task, highlighting selective integration.

Language: Английский

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