JNER: Robot-assisted evaluation of hand proprioception, motor and sensory impairments after stroke

For the hand, physical sensory and motor functions and the interaction between the two are essential for dexterity and proficiency in activities of daily living (ADL)
.

For example, when grasping a small object, proprioception is necessary to perceive the current position of the limb

Nerve damage such as stroke often disrupts certain aspects of this process, preventing the patient from undergoing ADL

Robot-assisted methods are objective (not dependent on the judgment of the observer), accurate (for example, able to measure accurate body position/force applied), and capable of providing precise and repeatable stimulation (for example, evaluating sensory function or Spasms])

In addition, through multiple robot-assisted evaluation tasks, one device can be used to evaluate different damages, which will lead to a more comprehensive overview of the time efficiency of damage
.

This also allows different injury modes (such as movement and sensation) to be compared with each other in a standardized way, which may provide new insights into upper limb injuries

The study of simultaneous validity is very important for linking new technical methods with generally accepted evaluation methods

This article was published in the " Journal of Neurology, Neurosurgery & Psychiatry " ( Journal of Neurology, Neurosurgery & Psychiatry )

A set of five supplementary assessment tasks were performed on a single-degree-of-freedom end effector robotic platform acting on the index finger metacarpophalangeal joints
.

Specifically, the position matching paradigm is used to assess proprioceptive impairment

A set of five supplementary assessment tasks were performed on a single-degree-of-freedom end effector robotic platform acting on the index finger metacarpophalangeal joints

83% of stroke patients with varying severity of injury (mild to severe) were able to complete all robotic tasks (each tested hand duration <15 minutes)

Schematic diagram of the robot platform

The newly proposed robot-assisted evaluation is reliable and does not show strong measurement errors
.

Demonstrating the reliability of proprioception assessment (measurement position matching task) is an important contribution, because it is a long-term challenge to reliably assess proprioceptive hand injuries in patients with the nervous system using traditional or robotic methods

Scales and results for assessing proprioceptive impairment

The reliability results obtained for motor and sensorimotor tasks are consistent with previously reported results in the literature ( ICC 0.
7-0.
9 , quality index), although it is difficult to directly compare these results because some studies are conducted on control subjects rather than target populations Of
.

Compared with traditional clinical evaluation, the proposed robot evaluation usually leads to higher measurement errors (for example, FMA 10% , our robot evaluation is between 15% and 25% )

ICC 0.
7-0.
9 FMA 10% 15% 25% In addition, it is clinically relevant to provide information on existing injuries on a subject basis
.
From the perspective of the percentage of subjects classified as damaged, this article found that not all stroke subjects scored worse than the control group, depending on the damage of stroke patients
.
In addition, providing information about existing injuries on a subject basis is clinically relevant
.
From the perspective of the percentage of subjects classified as damaged, this article found that not all stroke subjects scored worse than the control group, depending on the damage of stroke patients
.

There is a moderate to highly significant correlation between the outcome measures of each category of tasks (ie, proprioception, motor, sensorimotor assessment) and their corresponding clinical scores, which indicates the ability of the robotic measurement system to capture specific injuries
.
In more detail, a moderately significant correlation was found between the absolute error of position matching and kUDT , confirming that the robot task can evaluate proprioceptive defects
.
The fact that this robotic measurement is not related to FMA (only the movement part, because the sensory part of FMA is not implemented ) suggests that this task may be able to assess proprioception independently of sports injuries
.
In addition, the maximum force, active range of motion, and maximum speed have a strong and significant correlation with FMA , but no significant correlation with Kurt
.
Therefore, these robotic tasks may reflect impairments in basic motion execution
.

kUDT FMA FMA
.
In addition, the maximum force, active range of motion, and maximum speed have a strong and significant correlation with FMA , but no significant correlation with Kurt
.
Therefore, these robotic tasks may reflect impairments in basic motion execution
.

.
In addition, the maximum force, active range of motion, and maximum speed have a strong and significant correlation with FMA , but no significant correlation with Kurt
.
Therefore, these robotic tasks may reflect impairments in basic motion execution
.
FMA

The robot-assisted assessment proposed in this paper provides a clinically feasible, reliable and effective method to clearly describe the impairment of hand proprioception and motor function, as well as the interaction between the two
.
This opens up new avenues, helps to reveal the role of unique aspects of sensorimotor function in post-stroke recovery, and contributes to the development of personalized therapy in the future
.

The robot-assisted assessment proposed in this paper provides a clinically feasible, reliable and effective method to clearly describe the impairment of hand proprioception and motor function, as well as the interaction between the two
.
The robot-assisted assessment proposed in this paper provides a clinically feasible, reliable and effective method to clearly describe the impairment of hand proprioception and motor function, as well as the interaction between the two
.

Zbytniewska, M.
, Kanzler, CM, Jordan, L.
  et al.
Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke.
J NeuroEngineering Rehabil 18,  115 (2021).
https://doi.
org/10.
1186/s12984-021-00904-5   

Zbytniewska, M.
, Kanzler, CM, Jordan, L.
  et al.
Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke.
Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke.
J NeuroEngineering Rehabil 18,  115 (2021).
https://doi.
org/10.
1186/s12984-021-00904-5 Leave a message here