Abstract
Quantitative evaluation and training of the reach-to-target ability in stroke patients are needed for postdischarge rehabilitation, which can be achieved using a motion-tracking system. However, most of these systems are either costly, involve sophisticated parameter interpretation, or are not designed for rehabilitation. We developed an interactive reach-to-target assessment and training system (IRTATS) based on a camera and three marker straps to detect tracking signals. IRTATS supports audiovisual feedback, personal goal setting, and use in a small clinic or home without the internet. This study aims to evaluate the reliability, validity of IRTATS, and its measurement accuracy of the range of motion (ROM). Ninety-nine stroke patients and 20 healthy adults were recruited for the study. Kinematic variables and active joint ROM (AROM) were assessed using IRTATS. The AROM was measured by a universal goniometer, and scores from multiple clinical scales concerning motor and activity capability were calculated. Although the AROMs measured by IRTATS and the goniometer did not agree, IRTATS has clinically acceptable reliability and validity. Three variables in IRTATS could discriminate the motor performance of patients and healthy subjects. IRTATS may provide a new supplement to conventional physiotherapy in the assessment of the reach-to-target ability in stroke patients.
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Abbreviations
- UE:
-
Upper extremity
- IRTATS:
-
Interactive reach-to-target assessment and training system
- ICF:
-
International Classification of Functioning, Disability and Health
- AROM:
-
Active range of motion
- MT:
-
Movement time
- MV:
-
Maximum velocity
- NVP:
-
Number of velocity peak
- HPR:
-
Hand path ratio
- MMSE:
-
Mini-Mental State Examination
- MAS:
-
Modified Ashworth Scale
- FMA/UES:
-
UE section of the Fugl-Meyer Assessment
- MSS:
-
Motor Status Score
- ARAT:
-
Action Research Arm Test
- ICC:
-
Intraclass correlation coefficient
- SEM:
-
Standard error of measurement
- MDC:
-
Minimal detectable change
- MCID:
-
Minimal clinically important difference
- KR:
-
Knowledge of results
- KP:
-
Knowledge of performance
- IMU:
-
Inertial measurement unit
References
Coupar F, Pollock A, Rowe P, Weir C, Langhorne P (2012) Predictors of upper limb recovery after stroke: a systematic review and meta analysis. Clin Rehabil 26(4):291–313
Luinge HJ, Veltink PH (2005) Measuring orientation of human body segments using miniature gyroscopes and accelerometers. Med Biol Eng Comput 43(2):273–282
Zheng H, Black ND, Harris N (2005) Position-sensing technologies for movement analysis in stroke rehabilitation. Med Biol Eng Comput 43(4):413–420
Mobini A, Behzadipour S, Saadat M (2015) Test-retest reliability of Kinect’s measurements for the evaluation of upper body recovery of stroke patients. Biomed Eng Online 14:75–88
Yavuzer G, Senel A, Atay MB, Stam HJ (2008) “Playstation Eyetoy Games” improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial. Eur J Phys Rehabil Med 44(3):237–244
Neil A, Ens S, Pelletier R, Jarus T, Rand D (2013) Sony PlayStation EyeToy elicits higher levels of movement than the Nintendo Wii: implications for stroke rehabilitation. Eur J Phys Rehabil Med 49(1):13–21
Zhang SM, Hu HS, Zhou HY (2008) An interactive Internet-based system for tracking upper limb motion in home-based rehabilitation. Med Biol Eng Comput 46(3):241–249
Rand D, Kizony R, Weiss PT (2008) The Sony PlayStation II EyeToy: low-cost virtual reality for use in rehabilitation. J Neurol Phys Ther 32(4):155–163
Michaelsen SM, Jacobs S, Roby-Brami A, Levin MF (2004) Compensation for distal impairments of grasping in adults with hemiparesis. Exp Brain Res 157(2):162–173
Lennon SS, Baxter DD, Ashburn AA (2001) Physiotherapy based on the Bobath concept in stroke rehabilitation: a survey within the UK. Disabil Rehabil 23(6):254–262
de Los Reyes-Guzmán A, Dimbwadyo-Terrer I, Pérez-Nombela S et al (2017) Novel kinematic indices for quantifying upper limb ability and dexterity after cervical spinal cord injury. Med Biol Eng Comput 55(5):833–844
Graham JV, Eustace C, Brock K, Swain E, Irwin-Carruthers S (2009) The Bobath concept in contemporary clinical practice. Top Stroke Rehabil 16(1):57–68
Brunnstrom S (1966) Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther 46(4):357–375
Bogardus ST Jr, Yueh B, Shekelle PG (2003) Screening and management of adult hearing loss in primary care: clinical applications. JAMA 289(15):1986–1990
Singer O, Humpich M, Laufs H, Lanfermann H, Steinmetz H, Neumann-Haefelin T (2006) Conjugate eye deviation in acute stroke: incidence, hemispheric asymmetry, and lesion pattern. Stroke 37(11):2726–2732
Tuijl JP, Scholte EM, De Craen AJ et al (2012) Screening for cognitive impairment in older general hospital patients: comparison of the six-item cognitive test with the Mini-Mental Status Examination. Int J Geriatr Psychiatry 27(7):755–762
Pandyan AD, Johnson GR, Price CI, Curless RH, Barnes MP, Rodgers H (1999) A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clin Rehabil 13(5):373–383
Lang CE, Wagner JM, Bastian AJ et al (2005) Deficits in grasp versus reach during acute hemiparesis. Exp Brain Res 166(1):126–136
Riddle DL, Rothstein JM, Lamb RL (1987) Goniometric reliability in a clinical setting. Shoulder measurements. Phys Ther 67(5):668–673
Collins KC, Kennedy NC, Clark A et al (2018) Kinematic components of the reach-to-target movement after stroke for focused rehabilitation interventions: systematic review and meta-analysis. Front Neurol 9:472–495
De los Reyes-Guzman A, Dimbwadyo-Terrer I, Trincado-Alonso F et al (2014) Quantitative assessment based on kinematic measures of functional impairments during upper extremity movements: a review. Clin Biomech (Bristol, Avon) 29(7):719–727
Alt Murphy M, Willen C, Sunnerhagen KS (2012) Movement kinematics during a drinking task are associated with the activity capacity level after stroke. Neurorehabil Neural Repair 26(9):1106–1115
Merlo A, Longhi M, Giannotti E, Prati P, Giacobbi M, Ruscelli E, Mancini A, Ottaviani M, Montanari L, Mazzoli D (2013) Upper limb evaluation with robotic exoskeleton. Normative values for indices of accuracy, speed and smoothness. NeuroRehabilitation 33(4):523–530
Rabadi MH, Rabadi FM (2006) Comparison of the action research arm test and the Fugl-Meyer assessment as measures of upper-extremity motor weakness after stroke. Arch Phys Med Rehabil 87(7):962–966
Ferraro M, Demaio JH, Krol J, Trudell C, Rannekleiv K, Edelstein L, Christos P, Aisen M, England J, Fasoli S, Krebs HI, Hogan N, Volpe BT (2002) Assessing the motor status score: a scale for the evaluation of upper limb motor outcomes in patients after stroke. Neurorehabil Neural Repair 16(3):283–289
Platz T, Pinkowski C, van Wijck F, Kim IH, di Bella P, Johnson G (2005) Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Blocks Test: a multicentre study. Clin Rehabil 19(4):404–411
Nakagawa S, Cuthill IC (2007) Effect size, confidence interval and statistical significance: a practical guide for biologists. Biol Rev 82(4):591–605
Booth ML, Owen N, Bauman AE, Gore CJ (1996) Retest reliability of recall measures of leisure-time physical activity in Australian adults. Int J Epidemiol 25(1):153–159
Haley SM, Fragala-Pinkham MA (2006) Interpreting change scores of tests and measures used in physical therapy. Phys Ther 86(5):735–743
Wagner JM, Rhodes JA, Patten C (2008) Reproducibility and minimal detectable change of three-dimensional kinematic analysis of reaching tasks in people with hemiparesis after stroke. Phys Ther 88(5):652–663
Hoffmann T, Russell T, Cooke H (2007) Remote measurement via the Internet of upper limb range of motion in people who have had a stroke. J Telemed Telecare 13(8):401–405
Alt Murphy M, Willen C, Sunnerhagen KS (2011) Kinematic variables quantifying upper-extremity performance after stroke during reaching and drinking from a glass. Neurorehabil Neural Repair 25(1):71–80
Subramanian SK, Yamanaka J, Chilingaryan G, Levin MF (2010) Validity of movement pattern kinematics as measures of arm motor impairment poststroke. Stroke 41(10):2303–2308
Tobler-Ammann BC, De Bruin ED, Fluet M-C et al (2016) Concurrent validity and test-retest reliability of the Virtual Peg Insertion Test to quantify upper limb function in patients with chronic stroke. J Neuroeng Rehabil 13:8
Bosecker C, Dipietro L, Volpe B, Krebs HI (2010) Kinematic robot-based evaluation scales and clinical counterparts to measure upper limb motor performance in patients with chronic stroke. Neurorehabil Neural Repair 24(1):62–69
Van Dokkum L, Hauret I, Mottet D et al (2014) The contribution of kinematics in the assessment of upper limb motor recovery early after stroke. Neurorehabil Neural Repair 28(1):4–12
Alt Murphy M, Willén C, Sunnerhagen KS (2013) Responsiveness of upper extremity kinematic measures and clinical improvement during the first three months after stroke. Neurorehabil Neural Repair 27(9):844–853
Lachaine XR, Mecheri H, Larue C et al (2017) Validation of inertial measurement units with an optoelectronic system for whole-body motion analysis. Med Biol Eng Comput 55(4):609–619
Shin SH, Ro DH, Lee OS et al (2012) Within-day reliability of shoulder range of motion measurement with a smartphone. Man Ther 17(4):298–304
Rigoni M, Gill S, Babazadeh S et al (2019) Assessment of shoulder range of motion using a wireless inertial motion capture device—a validation study. Sensors (Basel) 19(8)
Lee SH, Yoon C, Chung SG, Kim HC, Kwak Y, Park HW, Kim K (2015) Measurement of shoulder range of motion in patients with adhesive capsulitis using a kinect. PLoS One 10(6):e0129398
Verbrugghe J, Knippenberg E, Palmaers S, Matheve T, Smeets W, Feys P, Spooren A, Timmermans A (2018) Motion detection supported exercise therapy in musculoskeletal disorders: a systematic review. Eur J Phys Rehabil Med 54(4):591–604
Greisberger A, Aviv H, Garbade SF, Diermayr G (2016) Clinical relevance of the effects of reach-to-grasp training using trunk restraint in in individuals with hemiparesis poststroke: a systematic review. J Rehabil Med 48(5):405–416
Baltaci G, Harput G, Haksever B et al (2013) Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction: prospective, randomized, controlled, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc 21(4):880–887
Seel T, Raisch J, Schauer T (2014) IMU-based joint angle measurement for gait analysis. Sensors (Basel) 14(4):6891–6909
Obdrzalek S, Kurillo G, Ofli F, et al (2012) Accuracy and robustness of Kinect pose estimation in the context of coaching of elderly population. Conf Proc IEEE Eng Med Biol Soc 1188-93
Webster D, Celik O (2014) Systematic review of Kinect applications in elderly care and stroke rehabilitation. J Neuroeng Rehabil 11:108
Çubukçu B, Yüzgeç U, Zileli R, Zileli A (2020) Reliability and validity analyzes of Kinect V2 based measurement system for shoulder motions. Med Eng Phys 76:20–31
Acknowledgments
The researchers would like to give thanks to all patients involved in the success of this research. In particular, we would like to thank Prof. Fang Li (Department of Rehabilitation Medicine, Huashan Hospital, Fudan University) for his assistance as a scientific adviser.
Funding
This study was supported by the National Key R&D Program of China (Grant No. 2018YFC2001700) in the design of the study and the collection and analysis of the data. This work is also part of the Stroke Rehabilitation Project funded by the Philips Investment Co. Ltd.
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The Ethics Committee of Huashan Hospital approved the study (HIRB protocol number KY2014-267), and all the participants gave their informed consent before the study.
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Fan, W., Zhang, Y., Wang, Q.M. et al. An interactive motion-tracking system for home-based assessing and training reach-to-target tasks in stroke survivors—a preliminary study. Med Biol Eng Comput 58, 1529–1547 (2020). https://doi.org/10.1007/s11517-020-02173-1
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DOI: https://doi.org/10.1007/s11517-020-02173-1