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Self-paced reaching after stroke: a quantitative assessment of longitudinal and directional sensitivity using the H-Man planar robot for upper limb neurorehabilitation

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Title: Self-paced reaching after stroke: a quantitative assessment of longitudinal and directional sensitivity using the H-Man planar robot for upper limb neurorehabilitation
Author(s): Hussain, A
Budhota, A
Hughes', CML
Dailey, WD
Vishwanath, DA
Kuah, CWK
Yam, LHL
Loh, YJ
Xiang, L
Chua, KSG
Burdet, E
Campolo, D
Item Type: Journal Article
Abstract: Technology aided measures offer a sensitive, accurate and time-efficient approach for the assessment of sensorimotor function after neurological insult compared to standard clinical assessments. This study investigated the sensitivity of robotic measures to capture differences in planar reaching movements as a function of neurological status (stroke, healthy), direction (front, ipsilateral, contralateral), movement segment (outbound, inbound), and time (baseline, post-training, 2-week follow-up) using a planar, two-degrees of freedom, robotic-manipulator (H-Man). Twelve chronic stroke (age: 55 ± 10.0 years, 5 female, 7 male, time since stroke: 11.2 ± 6.0 months) and nine aged-matched healthy participants (age: 53 ± 4.3 years, 5 female, 4 male) participated in this study. Both healthy and stroke participants performed planar reaching movements in contralateral, ipsilateral and front directions with the H-Man, and the robotic measures, spectral arc length (SAL), normalized time to peak velocities (TpeakN), and root-mean square error (RMSE) were evaluated. Healthy participants went through a one-off session of assessment to investigate the baseline. Stroke participants completed a 2-week intensive robotic training plus standard arm therapy (8 × 90 min sessions). Motor function for stroke participants was evaluated prior to training (baseline, week-0), immediately following training (post-training, week-2), and 2-weeks after training (follow-up, week-4) using robotic assessment and the clinical measures Fugl-Meyer Assessment (FMA), Activity-Research-Arm Test (ARAT), and grip-strength. Robotic assessments were able to capture differences due to neurological status, movement direction, and movement segment. Movements performed by stroke participants were less-smooth, featured longer TpeakN, and larger RMSE values, compared to healthy controls. Significant movement direction differences were observed, with improved reaching performance for the front, compared to ipsilateral and contralateral movement directions. There were group differences depending on movement segment. Outbound reaching movements were smoother and featured longer TpeakN values than inbound movements for control participants, whereas SAL, TpeakN, and RMSE values were similar regardless of movement segment for stroke patients. Significant change in performance was observed between initial and post-assessments using H-Man in stroke participants, compared to conventional scales which showed no significant difference. Results of the study indicate the potential of H-Man as a sensitive tool for tracking changes in performance compared to ordinal scales (i.e., FM, ARAT).
Publication Date: 25-Oct-2016
Date of Acceptance: 5-Oct-2016
URI: http://hdl.handle.net/10044/1/42925
DOI: http://dx.doi.org/10.3389/fnins.2016.00477
ISSN: 1662-4548
Publisher: Frontiers Media
Journal / Book Title: Frontiers in Neuroscience
Volume: 10
Issue: 477
Copyright Statement: © 2016 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Sponsor/Funder: Commission of the European Communities
Commission of the European Communities
Commission of the European Communities
Engineering & Physical Science Research Council (EPSRC)
Funder's Grant Number: 601003
611626
644727
EP/N032772/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Neurosciences
Neurosciences & Neurology
stroke
neurorehabilitation
robotic assessment
stroke rehabilitation
sensorimotor assessment
ASSISTED THERAPY
AIDED NEUROREHABILITATION
POINTING MOVEMENTS
PREMOTOR CORTEX
MOTOR RECOVERY
REHABILITATION
HEMIPARESIS
IMPAIRMENT
ARM
neurorehabilitation
robotic assessment
sensorimotor assessment
stroke
stroke rehabilitation
1109 Neurosciences
1702 Cognitive Science
Publication Status: Published
Article Number: ARTN 477
Appears in Collections:Faculty of Engineering
Bioengineering



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