A preliminary study for quantitative assessment of upper limb proprioception

Contu, Sara; Hussain, Asif; Masia, Lorenzo; Campolo, Domenico

doi:10.1109/embc.2016.7591755

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Young and Aged, where the age of the latter group was chosen to match the stroke patients' one. Similar to the results obtained for the arm proprioception [21], we found no significant changes in matching accuracy as a result of aging in the population analyzed. However, due to the small sample size and the absence of healthy participants older than 60 years, a further study is needed to confirm this finding, as previous studies on the effect of aging on proprioception which tested performance of older participants, reported a reduction of limb position acuity with aging [22], [23].…”

Section: Discussionsupporting

confidence: 89%

Wrist Proprioception in Acute and Subacute Stroke: A Robotic Protocol for Highly Impaired Patients

Contu

Basteris

Plunkett

et al. 2018

2018 7th IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob)

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Proprioception is a critical component of sensorimotor functions which directly affect recovery after neurological injuries. However, clinical tests of proprioception still lack sensitivity and reliability, while robotic devices can provide quantitative, accurate, and repeatable metrics. This work presents the analysis of the efficacy of a robotic assessment of wrist proprioception in terms of the capability to discern between movements along the different DoFs in a healthy population with a broad range of age. The effect of aging on the proprioceptive matching was analyzed to select an appropriate control group for the comparison with stroke patients, designed to confirm the hypothesis that a high percentage of stroke patients presents proprioceptive impairments in the acute and subacute states. Results show that the protocol is capable of detecting differences in performance along different movement directions, and that wrist proprioception does not deteriorate in the age ranges analyzed. Finally, stroke patients were less accurate in matching the position of their wrist, confirming the hypothesis that proprioceptive performance is often impaired in the acute and subacute phases of stroke.

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Section: Discussionsupporting

confidence: 89%

Wrist Proprioception in Acute and Subacute Stroke: A Robotic Protocol for Highly Impaired Patients

Contu

Basteris

Plunkett

et al. 2018

2018 7th IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob)

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“…We found no difference between them in either accuracy (F 1,22 =0.362 p=0.554) or in precision (F 1,22 =0.231 p=0.636). This is consistent with previous findings in a smaller population [46].…”

Section: Appendix a -Effect Of Age On Position Sense Performance In U...supporting

confidence: 94%

Upper Limb Position Matching After Stroke: Evidence for Bilateral Asymmetry in Precision but Not in Accuracy

Ballardini,

Cherpin,

Chua

et al. 2023

IEEE Access

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Assessment and rehabilitation of the upper limb after a stroke have primarily focused on the contralesional arm. However, increasing evidence highlights functional sensorimotor alterations also in the ipsilesional arm. This study aims to evaluate the position sense of both arms after a stroke using a passive position-matching task. We hypothesized that the ipsilesional arm would have higher accuracy and precision than the contralesional arm, but lower than the dominant arm in unimpaired participants. Additionally, we hypothesized a correlation in performance between the two arms in stroke survivors. The study included 40 stroke survivors who performed the proprioceptive test with both arms and 24 unimpaired participants who performed it with their dominant arm. During each trial, a planar robot moved their hand to a target and back. Participants had to indicate when their hand reached the target position in the second phase. We evaluated performance by computing the matching accuracy and precision. We found that the ipsilesional arm had similar matching accuracy but higher precision than the contralesional arm. Furthermore, only the matching accuracy of the two arms was correlated in the left and central regions of the workspace. When comparing stroke survivors to unimpaired participants, the ipsilesional arm exhibited significantly lower accuracy, yet not different precision. These findings support the notion that the ipsilesional arm is not 'unaffected' by stroke but rather 'less-affected', suggesting that stroke does not impact ipsilesional position sense precision. Additionally, the results suggest a dissociation between accuracy and precision in passive multi-joint position matching tasks.

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“…Beyond motor function and motion kinematic assessments, robotic devices could also be used to augment sensorimotor assessment by providing much needed proprioceptive assessment ( 50 , 52 ), which is poorly represented on standardized clinical scales, to get better insight on the evolution of each individual patients. Lastly, future work could extend the application of this combinatory approach using H-Man to treat acute stroke.…”

Section: Discussionmentioning

confidence: 99%

“…The participants who underwent the combinatory training scheme spent one third of the total therapy time in a 1:1 physical training with a therapist. For the rest of the training, the participants used the robot H-Man, a two-degree of freedom and compact upper limb rehabilitation and assessment device (44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54), under the minimal supervision of a therapist. One major aspect of this training scheme is that both of the groups received the same amount of training sessions, at a similar frequency and for the same amount of time, i.e., three therapy sessions per week over a span of 6 weeks.…”

Section: Introductionmentioning

confidence: 99%

Robotic Assisted Upper Limb Training Post Stroke: A Randomized Control Trial Using Combinatory Approach Toward Reducing Workforce Demands

et al. 2021

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Post stroke upper limb rehabilitation is a challenging problem with poor outcomes as 40% of survivors have functionally useless upper limbs. Robot-aided therapy (RAT) is a potential method to alleviate the effort of intensive, task-specific, repetitive upper limb exercises for both patients and therapists. The present study aims to investigate how a time matched combinatory training scheme that incorporates conventional and RAT, using H-Man, compares with conventional training toward reducing workforce demands. In a randomized control trial (NCT02188628, www.clinicaltrials.gov), 44 subacute to chronic stroke survivors with first-ever clinical stroke and predominant arm motor function deficits were recruited and randomized into two groups of 22 subjects: Robotic Therapy (RT) and Conventional Therapy (CT). Both groups received 18 sessions of 90 min; three sessions per week over 6 weeks. In each session, participants of the CT group received 90 min of 1:1 therapist-supervised conventional therapy while participants of the RT group underwent combinatory training which consisted of 60 min of minimally-supervised H-Man therapy followed by 30 min of conventional therapy. The clinical outcomes [Fugl-Meyer (FMA), Action Research Arm Test and, Grip Strength] and the quantitative measures (smoothness, time efficiency, and task error, derived from two robotic assessment tasks) were independently evaluated prior to therapy intervention (week 0), at mid-training (week 3), at the end of training (week 6), and post therapy (week 12 and 24). Significant differences within group were observed at the end of training for all clinical scales compared with baseline [mean and standard deviation of FMA score changes between baseline and week 6; RT: Δ4.41 (3.46) and CT: Δ3.0 (4.0); p < 0.01]. FMA gains were retained 18 weeks post-training [week 24; RT: Δ5.38 (4.67) and week 24 CT: Δ4.50 (5.35); p < 0.01]. The RT group clinical scores improved similarly when compared to CT group with no significant inter-group at all time points although the conventional therapy time was reduced to one third in RT group. There were no training-related adverse side effects. In conclusion, time matched combinatory training incorporating H-Man RAT produced similar outcomes compared to conventional therapy alone. Hence, this study supports a combinatory approach to improve motor function in post-stroke arm paresis.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02188628.

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A preliminary study for quantitative assessment of upper limb proprioception

Cited by 7 publications

References 17 publications

Wrist Proprioception in Acute and Subacute Stroke: A Robotic Protocol for Highly Impaired Patients

Wrist Proprioception in Acute and Subacute Stroke: A Robotic Protocol for Highly Impaired Patients

Upper Limb Position Matching After Stroke: Evidence for Bilateral Asymmetry in Precision but Not in Accuracy

Robotic Assisted Upper Limb Training Post Stroke: A Randomized Control Trial Using Combinatory Approach Toward Reducing Workforce Demands

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