Objective Assessment Of Motor Function Research Articles

Measurement and Analysis of Human Infant Crawling for Rehabilitation: A Narrative Review.

When a child shows signs of potential motor developmental disorders, early diagnosis of central nervous system (CNS) impairment is beneficial. Known as the first CNS-controlled mobility for most of infants, mobility during crawling usually has been used in clinical assessments to identify motor development disorders. The current clinical scales of motor development during crawling stage are relatively subjective. Objective and quantitative measures of infant crawling afford the possibilities to identify those infants who might benefit from early intervention, as well as the evaluation of intervention progress. Thus, increasing researchers have explored objective measurements of infant crawling in typical and atypical developing infants. However, there is a lack of comprehensive review on infant-crawling measurement and analysis toward bridging the gap between research crawling analysis and potential clinical applications. In this narrative review, we provide a practical overview of the most relevant measurements in human infant crawling, including acquisition techniques, data processing methods, features extraction, and the potential value in objective assessment of motor function in infancy; meanwhile, the possibilities to develop crawling training as early intervention to promote the locomotor function for infants with locomotor delays are also discussed.

The CatWalk XT® is a valid tool for objective assessment of motor function in the acute phase after controlled cortical impact in mice

BackgroundDespite multiple experimental models of traumatic brain injury (TBI) being available, objective assessment of gait and motor function in rodents remains difficult; therefore, we studied the value of the CatWalk XT® gait analysis as an observer independent, automated method for outcome assessment in one of the most frequently used preclinical TBI model, the controlled cortical impact (CCI), in mice. MethodsC57Bl/6 mice were subjected to either right parietal CCI or a sham procedure. Functional outcome was assessed using the CatWalk XT® (Version 10.6) as well as the hole board test at days one, three and seven after trauma induction. ResultsCCI led to diffuse, asymmetric and bilateral disturbances of both static and dynamic parameters in the CatWalk XT® gait analysis. The CatWalk XT® detected even minimal but statistically significant impairments that could not have been detected by clinical assessments. Impairments of static parameters were most pronounced within the first three days and diminished thereafter, while dynamic parameters were impaired until seven days after CCI. Fittingly, mice explored the hole board significantly less on day three trauma induction. ConclusionsThe CatWalk XT® is a valid tool for objective assessment of motor function in the acute phase after controlled cortical impact TBI in mice. Similar to observations made in humans, CCI leads to impairments of both static and dynamic parameters of gait and motor function which persist throughout the first week after the injury.

Automatic Outcome in Manual Dexterity Assessment Using Colour Segmentation and Nearest Neighbour Classifier.

Objective assessment of motor function is an important component to evaluating the effectiveness of a rehabilitation process. Such assessments are carried out by clinicians using traditional tests and scales. The Box and Blocks Test (BBT) is one such scale, focusing on manual dexterity evaluation. The score is the maximum number of cubes that a person is able to displace during a time window. In a previous paper, an automated version of the Box and Blocks Test using a Microsoft Kinect sensor was presented, and referred to as the Automated Box and Blocks Test (ABBT). In this paper, the feasibility of ABBT as an automated tool for manual dexterity assessment is discussed. An algorithm, based on image segmentation in CIELab colour space and the Nearest Neighbour (NN) rule, was developed to improve the reliability of automatic cube counting. A pilot study was conducted to assess the hand motor function in people with Parkinson’s disease (PD). Three functional assessments were carried out. The success rate in automatic cube counting was studied by comparing the manual (BBT) and the automatic (ABBT) methods. The additional information provided by the ABBT was analysed to discuss its clinical significance. The results show a high correlation between manual (BBT) and automatic (ABBT) scoring. The lowest average success rate in cube counting for ABBT was 92%. Additionally, the ABBT acquires extra information from the cubes’ displacement, such as the average velocity and the time instants in which the cube was detected. The analysis of this information can be related to indicators of health status (coordination and dexterity). The results showed that the ABBT is a useful tool for automating the assessment of unilateral gross manual dexterity, and provides additional information about the user’s performance.

Finger and foot tapping sensor system for objective motor assessment

Background/Aim. Finger tapping test is commonly used in neurological examinations as a test of motor performance. The new system comprising inertial and force sensors and custom proprietary software was developed for quantitative estimation and assessment of finger and foot tapping tests. The aim of this system was to provide diagnosis support and objective assessment of motor function. Methods. Miniature inertial sensors were placed on fingertips and used for measuring finger movements. A force sensor was placed on the fingertip of one finger, in order to measure the force during tapping. For foot tapping assessment, an inertial sensor was mounted on the subject?s foot, which was placed above a force platform. By using this system, various parameters such as a number of taps, tapping duration, rhythm, open and close speed, the applied force and tapping angle, can be extracted for detailed analysis of a patient?s motor performance. The system was tested on 13 patients with Parkinson?s disease and 14 healthy controls. Results. The system allowed easy measurement of listed parameters, and additional graphical representation showed quantitative differences in these parameters between neurological patient and healthy subjects. Conclusion. The novel system for finger and foot tapping test is compact, simple to use and efficiently collects patient data. Parameters measured in patients can be compared to those measured in healthy subjects, or among groups of patients, or used to monitor progress of the disease, or therapy effects. Created data and scores could be used together with the scores from clinical tests, providing the possibility for better insight into the diagnosis.

Towards an objective assessment of motor function in sub-acute stroke patients: Relationship between clinical rating scales and instrumental gait stability indexes

The assessment of walking function alterations is a key issue to design effective rehabilitative interventions in sub-acute stroke patients. Nevertheless, the objective quantification of these alterations remains a challenge.Clinical rating scales are commonly used in clinical practice, but have been proven prone to errors associated to the evaluator subjective perception. On the other hand, instrumental measurement of trunk acceleration can be exploited for an objective quantitative characterization of gait function, but it is not applied in routine clinical practice, because the resulting quantitative indexes have not been related to the clinically information, conventionally provided by the rating scales. To overcome this limitation, the relationship between the indexes, in specific clinical conditions, and rating scale must be better investigated, to support their exploitability in the clinical practice as a fast and reliable screening tool.Thirty-one sub-acute stroke patients (17 with and 14 without cane) participated in the study. All were assessed with 6 rating scales (MI, TCT, MRI, FAC, WHS, CIRS) and 2 functional tests (2MWT and TUG). Sample Entropy (SEN) and Recurrence Quantification Analysis (RQA) in AP, ML and V directions were calculated over 2MWT and walking section of TUG. The influence of assessment task and cane was analysed, as well as correlation of SEN and RQA indexes with clinical rating scales.SEN and RQA on the medio-lateral plane resulted influenced by the use of the cane, while the correlations between indexes and clinical scales showed that SEN and RQA for antero-posterior direction correlate positively with WHS.

Feasibility of spirography features for objective assessment of motor function in Parkinson's disease.

Parkinson's disease (PD) is currently incurable, however proper treatment can ease the symptoms and significantly improve the quality of life of patients. Since PD is a chronic disease, its efficient monitoring and management is very important. The objective of this paper was to investigate the feasibility of using the features and methodology of a spirography application, originally designed to detect early Parkinson's disease (PD) motoric symptoms, for automatically assessing motor symptoms of advanced PD patients experiencing motor fluctuations. More specifically, the aim was to objectively assess motor symptoms related to bradykinesias (slowness of movements occurring as a result of under-medication) and dyskinesias (involuntary movements occurring as a result of over-medication). This work combined spirography data and clinical assessments from a longitudinal clinical study in Sweden with the features and pre-processing methodology of a Slovenian spirography application. The study involved 65 advanced PD patients and over 30,000 spiral-drawing measurements over the course of three years. Machine learning methods were used to learn to predict the "cause" (bradykinesia or dyskinesia) of upper limb motor dysfunctions as assessed by a clinician who observed animated spirals in a web interface. The classification model was also tested for comprehensibility. For this purpose a visualisation technique was used to present visual clues to clinicians as to which parts of the spiral drawing (or its animation) are important for the given classification. Using the machine learning methods with feature descriptions and pre-processing from the Slovenian application resulted in 86% classification accuracy and over 0.90 AUC. The clinicians also rated the computer's visual explanations of its classifications as at least meaningful if not necessarily helpful in over 90% of the cases. The relatively high classification accuracy and AUC demonstrates the usefulness of this approach for objective monitoring of PD patients. The positive evaluation of computer's explanations suggests the potential use of this methodology in a decision support setting.

Motor Function Outcome Assessment by Grip and Pinch Strength Following Carpal Tunnel Release

Objective: Carpal tunnel syndrome is the commonest compression neuropathy of upper limb in practice and is extensively studied condition. Objective assessment of motor function is useful to evaluate outcome after surgical procedure. There appears to be controversy on which motor function change recovery after the release. This study was conducted to compare pinch and grip strength of patients with carpal tunnel syndrome undergoing release to normative values preoperatively and postoperatively. Methods: Clinical information collected on grip and pinch strength of 50 hands with carpal tunnel syndrome was compared to appropriately match normative data. Findings: There were definite improvements in strength after 4 weeks postsurgical release and some subjects continued to have significant deficits compared to the normative data. Applications: Patients with carpal tunnel syndrome have moderate to large weakness in grip and pinch strength in comparison to normative data. Carpal Tunnel Release may reduce this weakness; however, carpal tunnel syndrome patients may often have with residual problems at 4 weeks and may take up to 1 year to resolve completely

I09 Optical motion sensing device (kinect) to assess motor function in HD—a pilot study

<h3>Background</h3> Motor impairment is an essential milestone in the clinical course of HD and motor age of onset is an important end point in genetic modifier studies. Objective assessment of motor function is therefore an important clinical endpoint. To date motor assessment relies on a clinical rating, ideally through an experienced rater following a standardised clinical scoring system, for example, the UHDRS. However, even under optimal circumstances, this approach is limited by inter- and intrarater variability and subjective error. More automated tools for motor assessment are available but expensive, technically involved and time consuming. <h3>Aims</h3> We sought to determine whether consumer electronic gaming devices (Kinect) can be used to analyse movement disturbances in symptomatic HD patients. <h3>Methods</h3> We used a Kinect developers kit and a custom-made user-interface to record and analyse movements of HD patients and controls in a clinical setting. <h3>Results</h3> Preliminary measurements/data of our pilot study suggest that Kinect device can be useful to objectively analyse chorea in HD patients and possibly other neurologic disorders. <h3>Conclusion</h3> A Kinect device is potentially useful for recording and analysing neurologic movement disorders, including HD.