Lower Extremity Motor Coordination Test Research Articles

Lower Limb Motor Coordination of Stroke Survivors, Based Upon Their Levels of Motor Recovery and Ages

Objective: To describe the motor coordination (MC) of the paretic lower limb of stroke survivors based upon their levels of motor recovery and ages and to compare their LEMOCOT scores with those predicted for healthy subjects of similar ages and genders. Methods: MC was assessed by the Lower Extremity Motor Coordination Test (LEMOCOT). The participants were divided, according to their ages and levels of motor recovery, based upon the Fugl-Meyer (FM) lower limb section scores (mild impairments: FM ≥ 23 and severe impairments: FM <23). To compare the LEMOCOT scores of the paretic lower limb with those predicted for healthy subjects, the predicted equations for the non-dominant lower limb of healthy subjects of similar ages and genders were employed. Results/Discussion: Age did not influence the LEMOCOT scores, but the subjects with severe motor impairments always showed lower scores, when compared to those with mild impairments, regardless of their ages. The subjects with mild motor impairments reached 75%, while those with severe motor impairments reached only 20% of the predicted scores for healthy subjects. Conclusions: The findings suggested that the subjects with mild motor impairments had better MC, than those with severe impairments, regardless of their ages. Furthermore, the subjects with mild motor impairments reached 75%, whereas those with severe impairments reached only 20% of the predicted scores for healthy subjects

Measurement Properties of the Lower Extremity Motor Coordination Test in Stroke Survivors

Measurement Properties of the Lower Extremity Motor Coordination Test in Stroke Survivors

Reference Values and Psychometric Properties of the Lower Extremity Motor Coordination Test

Objectives(1) To create predictive nomograms for the dominant and nondominant limbs on the Lower Extremity Motor Coordination Test (LEMOCOT) using reference values, and (2) to determine the inter- and intrarater reliability for the LEMOCOT; the best scoring method (first vs mean of the first 2 vs mean of the last 2 vs mean of 3 vs the highest of 3 trials); the best testing method (direct vs video observation); and the ability to detect real change (smallest real difference [SRD] and standard error of the measurement [SEM]). DesignNormative and methodological study. SettingMetropolitan area. ParticipantsHealthy individuals (N=320, 50% women) in 7 age groups: 20 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and ≥80 years. Each group had 50 participants, except for ≥80 years (n=20). InterventionsNot applicable. Main Outcome MeasureLEMOCOT. ResultsAge and sex explained 48% of the variance in the LEMOCOT scores for the dominant limb and 44% for the nondominant limb (125<F<148; P<.001). No significant differences were found regarding the different scoring methods (.12<F<1.02; .10<P<.92), and all of them demonstrated good reliability (intraclass correlation coefficients between .90 and .99; P<.001). There was agreement between scores from direct and video observation (limits of agreement −1.99 to 1.85; −1.55 to 1.62). Appropriate SEM (2.27–1.85) and SRD (6.27–5.11) values were found. ConclusionsReference values were determined for the LEMOCOT, and predictive nomograms were created based on age and sex. The LEMOCOT is reliable, needing only 1 trial (after familiarization) to generate reliable scores; can be scored from either direct or video observation; and has the ability to detect real change over time.

Reliability and Validity of Step Test Scores in Subjects With Chronic Stroke

Hong S-J, Goh EY, Chua SY, Ng SS. Reliability and validity of step test scores in subjects with chronic stroke. ObjectivesTo establish (1) the intrarater and interrater reliabilities of step test (ST) scores in subjects with chronic stroke, (2) the ST's known-groups validity and cutoff scores for distinguishing subjects with chronic stroke from healthy adults older than 50 years, and (3) the convergent validity of ST scores with lower-limb muscle strength, coordination, balance performance, and walking speed. DesignCross-sectional study. SettingUniversity-based rehabilitation center. ParticipantsConvenience sample of subjects (N=30): community-dwelling subjects with chronic stroke (n=15) and healthy adults older than 50 years (n=15). InterventionsNot applicable. Main Outcome MeasuresST scores; handheld dynamometer measurements of bilateral lower-limb muscle strength; lower-extremity motor coordination test (LEMOCOT) scores; Berg Balance Scale scores; walking speed as measured by a 5-meter walk test. ResultsST scores showed excellent intrarater reliability, with intraclass correlation coefficients ranging from .981 to .995 and interrater reliability ranging from .996 to .999. A cutoff score of 13 on the paretic side was found to distinguish the healthy adults older than 50 years from subjects with stroke at a sensitivity of 87% and a specificity of 87%. A cutoff score of 11 on the nonparetic side was found to distinguish the healthy adults from subjects with stroke at a sensitivity of 100% and a specificity of 67%. ST scores of the paretic limb demonstrated a significant correlation with muscle strength, the LEMOCOT scores of the paretic leg, and walking speed. ST scores of the nonparetic limb demonstrated a significant correlation with muscle strength and the LEMOCOT scores of the paretic leg. ConclusionsThe ST is a reliable measurement tool when the number of steps is counted by either experienced or inexperienced examiners by viewing videotapes. ST scores with both the paretic limb and the nonparetic limb are sensitive in distinguishing subjects with chronic stroke from healthy adults older than 50 years.

ASSESSMENT OF LOWER EXTREMITY MOTOR COORDINATION IN OPERATED PATIENTS

Objective: To establish any changes up to the second postoperative month in pain, disability, performance, kinesiophobia, and lower extremity motor coordination of patients operated on for lumbar disc hernia. Methods: Forty-five patients with lumbar disc hernia were included in the study preoperatively, and were followed up until the second postoperative month. Pain and disability, walking and stair-climbing performances, and kinesiophobia were measured; and motor coordination tests were practiced with the Lower Extremity MOtor COordination Test (LEMOCOT). Results: The worst scores of pain, disability, performance, kinesiophobia, and LEMOCOT measurements were in the preoperative period; while the best ones were observed in the 2 months following the surgery. Conclusion: The measurements of pain, disability, performance, kinesiophobia, and lower extremity coordination usually performed in the cases operated on with a diagnosis of lumbar disc hernia are significantly affected from the initial period until the second postoperative month.

Validation of a New Lower-Extremity Motor Coordination Test

Desrosiers J, Rochette A, Corriveau H. Validation of a new lower-extremity motor coordination test. Objective To determine the test-retest reliability and construct validity of a new lower-extremity motor coordination test, the Lower Extremity MOtor COordination Test (LEMOCOT). Design To test reliability, subjects with impairments in at least 1 lower extremity were evaluated twice by the same evaluator. To test construct validity, the LEMOCOT scores obtained from subjects who had had a stroke were correlated with physical, functional, cognitive, and perceptual tests. Setting Geriatric day hospital and functional intensive rehabilitation unit. Participants In the reliability test, 29 people (mean age, 69.6y; range, 28–87y); in the construct validity, 144 people who recently had had a stroke. Intervention Not applicable. Main outcome measures In addition to the LEMOCOT, the following measures were used for construct validity: the Fugl-Meyer Assessment (motor function), Berg Balance Scale, 5-m walking test, 2-minute walking test, Functional Autonomy Measurement System, Modified Mini-Mental State Examination, and Motor-Free Visual Perceptual Test. Results Intraclass correlation coefficients (ICCs) indicated that test-retest reliability is good (right-side ICC=.88; left-side ICC=.83). The construct validity of the LEMOCOT was demonstrated by obtaining high correlations with physical and functional tests ( r range, .62–.79; P<.001) and no correlations with cognitive ( r=.11, P=.20) or visual perceptual tests ( r=.15, P=.08) and by discriminating between subjects discharged to long-term care versus other living environments ( P<.001). Conclusions The LEMOCOT is a simple lower-extremity motor coordination test that showed good test-retest reliability and construct validity. It can be used in clinical and research settings, specifically with people who have had a stroke. Other studies should be carried out to confirm its psychometric properties.