Abstract
BackgroundAfter stroke, kinematic measures obtained with non-robotic and robotic devices are highly recommended to precisely quantify the sensorimotor impairments of the upper-extremity and select the most relevant therapeutic strategies. Although the ArmeoSpring exoskeleton has demonstrated its effectiveness in stroke motor rehabilitation, its interest as an assessment tool has not been sufficiently documented. The aim of this study was to investigate the psychometric properties of selected kinematic parameters obtained with the ArmeoSpring in post-stroke patients.MethodsThis study involved 30 post-stroke patients (mean age = 54.5 ± 16.4 years; time post-stroke = 14.7 ± 26.7 weeks; Upper-Extremity Fugl-Meyer Score (UE-FMS) = 40.7 ± 14.5/66) who participated in 3 assessment sessions, each consisting of 10 repetitions of the ‘horizontal catch’ exercise. Five kinematic parameters (task and movement time, hand path ratio, peak velocity, number of peak velocity) and a global Score were computed from raw ArmeoSpring’ data. Learning effect and retention were analyzed using a 2-way repeated-measures ANOVA, and reliability was investigated using the intra-class correlation coefficient (ICC) and minimal detectable change (MDC).ResultsWe observed significant inter- and intra-session learning effects for most parameters except peak velocity. The measures performed in sessions 2 and 3 were significantly different from those of session 1. No additional significant difference was observed after the first 6 trials of each session and successful retention was also highlighted for all the parameters. Relative reliability was moderate to excellent for all the parameters, and MDC values expressed in percentage ranged from 42.6 to 102.8%.ConclusionsAfter a familiarization session, the ArmeoSpring can be used to reliably and sensitively assess motor impairment and intervention effects on motor learning processes after a stroke.Trial registration The study was approved by the local hospital ethics committee in September 2016 and was registered under number 05-0916.
Highlights
After stroke, kinematic measures obtained with non-robotic and robotic devices are highly recom‐ mended to precisely quantify the sensorimotor impairments of the upper-extremity and select the most relevant therapeutic strategies
Of mDiff not including zero) can be seen, reflecting an improvement between sessions 2 and 3. In this pilot study, kinematic parameters computed from data provided by the ArmeoSpring exoskeleton were analyzed to investigate the relevance of these parameters in the assessment of post-stroke hemiplegic patients during a 2D-horizontal catching exercise
The fast and early improvement of this parameter was considered to reflect the improvement of performance due to learning processes, while its late and slower improvement was considered to reflect a reduction of upper extremity (UE) motor impairments
Summary
Kinematic measures obtained with non-robotic and robotic devices are highly recom‐ mended to precisely quantify the sensorimotor impairments of the upper-extremity and select the most relevant therapeutic strategies. Clinical scales are not always appropriate to assess motor strategies during movements, and they are not sensitive enough to capture the quality of sensorimotor performance or the effectiveness of therapeutic interventions [4]. Some authors recommend using kinematic parameters provided by optokinetic, robotic or gravity-supporting devices to assess movements [5,6,7,8,9,10] These parameters are thought to be more sensitive and provide more information on movement performance and quality in the context of health and disease, helping to fill the gap related to the use of clinical scales
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