Assessment of upper-limb sensorimotor function of subacute stroke patients using visually guided reaching

Neurorehabil Neural Repair. Jul-Aug 2010;24(6):528-41. doi: 10.1177/1545968309356091. Epub 2010 Mar 16.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arm / innervation
  • Arm / physiopathology*
  • Disability Evaluation*
  • Female
  • Functional Laterality / physiology
  • Humans
  • Male
  • Middle Aged
  • Movement Disorders / diagnosis*
  • Movement Disorders / physiopathology
  • Paresis / diagnosis*
  • Paresis / physiopathology
  • Psychomotor Performance / physiology*
  • Robotics / instrumentation
  • Robotics / methods
  • Stroke / diagnosis*
  • Stroke / physiopathology
  • Young Adult