The Virtual Peg Insertion Test as an assessment of upper limb coordination in ARSACS patients: a pilot study

J Neurol Sci. 2014 Dec 15;347(1-2):341-4. doi: 10.1016/j.jns.2014.09.032. Epub 2014 Sep 28.

Abstract

Objective: This paper introduces a novel assessment tool to provide clinicians with quantitative and more objective measures of upper limb coordination in patients suffering from Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS). The Virtual Peg Insertion Test (VPIT) involves manipulating an instrumented handle in order to move nine pegs into nine holes displayed in a virtual environment. The main outcome measures were the number of zero-crossings of the hand acceleration vector, as a measure of movement coordination and the total time required to complete the insertion of the nine pegs, as a measure of overall upper limb performance.

Results: 8\9 patients with ARSACS were able to complete five repetitions with the VPIT. Patients were found to be significantly less coordinated and slower than age-matched healthy subjects (p<0.01). Performance of ARSACS patients was positively correlated with the Nine-Hole Peg Test (r=0.85, p<0.01) and with age (r=0.93, p<0.01), indicative of the degenerative nature of the disease.

Conclusion(s): This study presents preliminary results on the use of a robotics and virtual reality assessment tool with ARSACS patients. Results highlight its potential to assess impaired coordination and monitor its progression over time.

Keywords: Coordination; Instrument; Instrumented assessment tool; Outcome assessment (health care); Spastic Ataxia of Charlevoix–Saguenay type; User–computer interface.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ataxia / etiology
  • Ataxia / physiopathology
  • Ataxia / rehabilitation*
  • Biomechanical Phenomena
  • Equipment Design / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Skills*
  • Muscle Spasticity / complications
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / rehabilitation*
  • Pilot Projects
  • Rehabilitation / instrumentation*
  • Rehabilitation / methods
  • Spinocerebellar Ataxias / complications
  • Spinocerebellar Ataxias / congenital*
  • Spinocerebellar Ataxias / physiopathology
  • Spinocerebellar Ataxias / rehabilitation
  • Task Performance and Analysis
  • Upper Extremity / physiopathology*

Supplementary concepts

  • Spastic ataxia Charlevoix-Saguenay type