Assessment of Upper-Limb Sensorimotor Function of Subacute Stroke Patients Using Visually Guided Reaching
Assessment of Upper-Limb Sensorimotor Function of Subacute Stroke Patients Using Visually Guided Reaching
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DOI：
10.1177/1545968309356091
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发表时间：
2010-07-01
影响因子：
4.2
通讯作者：
Scott, Stephen H.
中科院分区：
文献类型：
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作者：
Coderre, Angela M.;Abou Zeid, Amr;Scott, Stephen H.
目标。使用机器人技术，我们检查了视觉引导的到达任务的能力，以评估中风患者的感觉运动功能。方法。91名健康参与者和52名轻中度亚急性中风患者（26名左侧和26名右侧患者）使用KINARM机器人完成了一项无辅助的伸手任务。每个参与者使用12个运动参数进行评估，这些参数分为5个感觉运动控制属性。结果。许多运动参数单独识别出大量中风参与者与95%的对照组不同——最显著的是初始方向误差，它识别出81%的左患病者。我们还发现，与对照组相比，中风患者手臂之间的肢体间表现存在差异。例如，只有31%的左患参与者的反应时间与他们的左患手臂不同，54%的人在反应时间上表现出异常的肢间差异。12个运动参数中有9个具有良好的互译信度（r > 0.7）。最后，在切多克-麦克马斯特中风评估量表中，许多被认为在到达任务中受损的中风患者的手臂部分得分为6分或更低，但一些得分正常的7分的患者也被认为在到达任务中受损。结论。与标准的临床评估量表相比，使用视觉引导的机器人技术可以提供更可靠的信息，更敏感地了解患者中风后的感觉运动障碍。
Objective. Using robotic technology, we examined the ability of a visually guided reaching task to assess the sensorimotor function of patients with stroke. Methods. Ninety-one healthy participants and 52 with subacute stroke of mild to moderate severity (26 with left- and 26 with right-affected body sides) performed an unassisted reaching task using the KINARM robot. Each participant was assessed using 12 movement parameters that were grouped into 5 attributes of sensorimotor control. Results. A number of movement parameters individually identified a large number of stroke participants as being different from 95% of the controls-most notably initial direction error, which identified 81% of left-affected patients. We also found interlimb differences in performance between the arms of those with stroke compared with controls. For example, whereas only 31% of left-affected participants showed differences in reaction time with their affected arm, 54% showed abnormal interlimb differences in reaction time. Good interrater reliability (r > 0.7) was observed for 9 of the 12 movement parameters. Finally, many stroke patients deemed impaired on the reaching task had been scored 6 or less on the arm portion of the Chedoke-McMaster Stroke Assessment Scale, but some who scored a normal 7 were also deemed impaired in reaching. Conclusions. Robotic technology using a visually guided reaching task can provide reliable information with greater sensitivity about a patient's sensorimotor impairments following stroke than a standard clinical assessment scale.