Association Between Finger-to-Nose Kinematics and Upper Extremity Motor Function in Subacute Stroke: A Principal Component Analysis.

Ze-Jian Chen,Nan Xia,Yang-An Li,Xiao-Lin Huang,Ming-Hui Gu,Cai-Hua Xiong,Chang He,Jiang Xu

doi:10.3389/fbioe.2021.660015

Abstract

BackgroundKinematic analysis facilitates interpreting the extent and mechanisms of motor restoration after stroke. This study was aimed to explore the kinematic components of finger-to-nose test obtained from principal component analysis (PCA) and the associations with upper extremity (UE) motor function in subacute stroke survivors.MethodsThirty-seven individuals with subacute stroke and twenty healthy adults participated in the study. Six kinematic metrics during finger-to-nose task (FNT) were utilized to perform PCA. Clinical assessments for stroke participants included the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Modified Barthel Index (MBI).ResultsThree principal components (PC) accounting for 91.3% variance were included in multivariable regression models. PC1 (48.8%) was dominated by mean velocity, peak velocity, number of movement units (NMU) and normalized integrated jerk (NIJ). PC2 (31.1%) described percentage of time to peak velocity and movement time. PC3 (11.4%) profiled percentage of time to peak velocity. The variance explained by principal component regression in FMA-UE (R2 = 0.71) were higher than ARAT (R2 = 0.59) and MBI (R2 = 0.29) for stroke individuals.ConclusionKinematic components during finger-to-nose test identified by PCA are associated with UE motor function in subacute stroke. PCA reveals the intrinsic association among kinematic metrics, which may add value to UE assessment and future intervention targeted for kinematic components for stroke individuals.Clinical Trial RegistrationChinese Clinical Trial Registry (http://www.chictr.org.cn/) on 17 October 2019, identifier: ChiCTR1900026656.

Highlights

Stroke is the leading cause of disability worldwide, and upper extremity (UE) motor impairment is one of the most relevant functions affected in stroke (Langhorne et al, 2009; GBD, 2019)
The variance explained by principal component regression in Fugl-Meyer Assessment of Upper Extremity (FMA-UE) (R2 = 0.71) were higher than Action Research Arm Test (ARAT) (R2 = 0.59) and Modified Barthel Index (MBI) (R2 = 0.29) for stroke individuals
Kinematic components during finger-to-nose test identified by principal component analysis (PCA) are associated with UE motor function in subacute stroke

Summary

Introduction

Stroke is the leading cause of disability worldwide, and upper extremity (UE) motor impairment is one of the most relevant functions affected in stroke (Langhorne et al, 2009; GBD, 2019). According to the International Classification of Functioning, Disability and Health (ICF) (WHO, 2001), there have been extensive validated UE scales on body function and activity, among which the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Modified Barthel Index (MBI) are commonly utilized in clinical practice (Santisteban et al, 2016). These ordinal rating scales may carry the potential for examiner bias and lack sensitivity to quantify small but potentially impacting change over time (Lang et al, 2013). This study was aimed to explore the kinematic components of finger-to-nose test obtained from principal component analysis (PCA) and the associations with upper extremity (UE) motor function in subacute stroke survivors

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