Robotic measurement of arm movements after stroke establishes biomarkers of motor recovery.
Robotic measurement of arm movements after stroke establishes biomarkers of motor recovery.
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DOI：
10.1161/strokeaha.113.002296
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发表时间：
2014-01
期刊：
影响因子：
8.3
通讯作者：
Volpe BT
中科院分区：
文献类型：
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作者：
Krebs HI;Krams M;Agrafiotis DK;DiBernardo A;Chavez JC;Littman GS;Yang E;Byttebier G;Dipietro L;Rykman A;McArthur K;Hajjar K;Lees KR;Volpe BT
由于机器人设备以高分辨率记录人类运动的运动学和动力学，我们假设在中风后患者纵向收集的机器人测量值与标准临床结果测量值有显著关系，因此可能提供更好的生物标志物。在中重度急性缺血性脑卒中患者中，我们使用临床量表和机器人设备在两个临床地点测量事件发生后7、14、21、30和90天的手臂运动。机器人是交互装置，可以测量速度、位置和力，以便计算出的运动学和动力学参数可以与临床评估进行比较。208例患者中，机器人测量能较好地预测临床测量（修正Rankin量表交叉验证R2 =0.60；国立卫生研究院卒中量表交叉验证R2 =0.63； Fugl-Meyer量表交叉验证R2 =0.73； Motor Power量表交叉验证R2 =0.75）。当适当缩放并结合人工神经网络时，机器人测量在测量患者从第7天到第90天的恢复方面表现出更高的灵敏度（增加的标准化效应=1.47）。这些结果表明，机器人对运动性能的测量将更充分地捕获结果，并且改变的效应大小将减少所需的样本量。减少样本量可能会提高研究效率。
Because robotic devices record the kinematics and kinetics of human movements with high resolution, we hypothesized that robotic measures collected longitudinally in patients after stroke would bear a significant relationship to standard clinical outcome measures and, therefore, might provide superior biomarkers. In patients with moderate-to-severe acute ischemic stroke, we used clinical scales and robotic devices to measure arm movement 7, 14, 21, 30, and 90 days after the event at 2 clinical sites. The robots are interactive devices that measure speed, position, and force so that calculated kinematic and kinetic parameters could be compared with clinical assessments. Among 208 patients, robotic measures predicted well the clinical measures (cross-validated R2 of modified Rankin scale=0.60; National Institutes of Health Stroke Scale=0.63; Fugl-Meyer=0.73; Motor Power=0.75). When suitably scaled and combined by an artificial neural network, the robotic measures demonstrated greater sensitivity in measuring the recovery of patients from day 7 to day 90 (increased standardized effect=1.47). These results demonstrate that robotic measures of motor performance will more than adequately capture outcome, and the altered effect size will reduce the required sample size. Reducing sample size will likely improve study efficiency.