Background: Existing clinical scores of upper limb function often use observer-based ordinal scales that are subjective and commonly have floor and ceiling effects. The purpose of the present study was to develop an upper limb motor task to assess objectively the ability of participants to select and engage motor actions with both hands.
Methods: A bilateral robotic system was used to quantify upper limb sensorimotor function of participants with stroke. Participants performed an object hit task that required them to hit virtual balls moving towards them in the workspace with virtual paddles attached to each hand. Task difficulty was initially low, but increased with time by increasing the speed and number of balls in the workspace. Data were collected from 262 control participants and 154 participants with recent stroke.
Results: Control participants hit ~60 to 90% of the 300 balls with relatively symmetric performance for the two arms. Participants with recent stroke performed the task with most participants hitting fewer balls than 95% of healthy controls (67% of right-affected and 87% of left-affected strokes). Additionally, nearly all participants (97%) identified with visuospatial neglect hit fewer balls than healthy controls. More detailed analyses demonstrated that most participants with stroke displayed asymmetric performance between their affected and non-affected limbs with regards to number of balls hit, workspace area covered by the limb and hand speed. Inter-rater reliability of task parameters was high with half of the correlations above 0.90. Significant correlations were observed between many of the task parameters and the Functional Independence Measure and/or the Behavioural Inattention Test.
Conclusions: As this object hit task requires just over two minutes to complete, it provides an objective and easy approach to quantify upper limb motor function and visuospatial skills following stroke.