Abstract
BackgroundThe lower-extremity motor coordination test (LEMOCOT) is a performance-based measure used to assess motor coordination deficits after stroke. We aimed to automatically quantify performance on the LEMOCOT and to extract additional performance parameters based on error analysis in persons with stroke (PwS) and healthy controls. We also aimed to explore whether these parameters provide additional information regarding motor control deficit that is not captured by the traditional LEMOCOT score. In addition, the associations between the LEMOCOT score, parameters of error and performance-based measures of lower-extremity impairment and gait were tested.MethodsTwenty PwS (age: 62 ± 11.8 years, time after stroke onset: 84 ± 83 days; lower extremity Fugl-Meyer: 30.2 ± 3.7) and 20 healthy controls (age: 42 ± 15.8 years) participated in this cross-sectional exploratory study. Participants were instructed to move their big toe as fast and accurately as possible between targets marked on an electronic mat equipped with force sensors (Zebris FDM-T, 60 Hz). We extracted the contact surface area of each touch, from which the endpoint location, the center of pressure (COP), and the distance between them were computed. In addition, the absolute and variable error were calculated.ResultsPwS touched the targets with greater foot surface and demonstrated a greater distance between the endpoint location and the location of the COP. After controlling for the number of in-target touches, greater absolute and variable errors of the endpoint were observed in the paretic leg than in the non-paretic leg and the legs of controls. Also, the COP variable error differentiated between the paretic, non-paretic, and control legs and this parameter was independent of in-target counts. Negative correlations with moderate effect size were found between the Fugl Meyer assessment and the error parameters.ConclusionsPwS demonstrated lower performance in all outcome measures than did controls. Several parameters of error indicated differences between legs (paretic leg, non-paretic leg and controls) and were independent of in-target touch counts, suggesting they may reflect motor deficits that are not identified by the traditional LEMOCOT score.
Highlights
Motor coordination can be defined as the ability to produce context-dependent organized movements in spatial and temporal domains [1, 2]
We aimed to (1) estimate the validity of our algorithm and script, (2) quantify motor performance in the lower-extremity motor coordination test (LEMOCOT) using parameters of error in persons with stroke (PwS) and healthy controls, (3) investigate whether these parameters provide different or additional information to that provided by the traditional score, and (4) to determine the association between the traditional LEMOCOT score, parameters of error and performance-based measures of lower extremity motor impairments and gait
Associations between the LEMOCOT score, paretic leg’s error and performance‐based measures of motor impairments and gait Negative correlations with moderate effect size were found between the Fugl Meyer assessment and the endpoint variable error (r = −0.348, p = 0.037), center of pressure (COP) absolute error (r = −0.384, p = 0.021) and COP variable error (r = −0.427, p = 0.009)
Summary
Motor coordination can be defined as the ability to produce context-dependent organized movements in spatial and temporal domains [1, 2]. A quantitative evaluation of the endpoint movement to target in terms of smoothness, straightness, error magnitude, speed and range of joint motion might provide a more refined and informative scale to characterize motor control deficits after stroke than merely time and criterion [11]. We focus on quantifying the error (i.e., accuracy) of the performance in the lower-extremity motor coordination test (LEMOCOT) in persons with stroke (PwS). The lower-extremity motor coordination test (LEMOCOT) is a performance-based measure used to assess motor coordination deficits after stroke. We aimed to automatically quantify performance on the LEMOCOT and to extract additional performance parameters based on error analysis in persons with stroke (PwS) and healthy controls. The associations between the LEMOCOT score, parameters of error and performance-based measures of lower-extremity impairment and gait were tested
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