Assessment of upper limb motor function in patients with multiple sclerosis using the Virtual Peg Insertion Test: A pilot study

Lambercy, Olivier; Fluet, Marie-Christine; Lamers, Ilse; Kerkhofs, Lore; Feys, Peter; Gassert, Roger

doi:10.1109/icorr.2013.6650494

Cited by 31 publications

(26 citation statements)

References 23 publications

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“…This hypothesis was evaluated in 30 chronic post-stroke subjects. Twenty-three of these, the ones with mild to moderate sensorimotor impairments and without strong cognitive deficits, were able to successfully complete the goal-directed manipulation task protocol with their most affected body side, thereby confirming previous reports about the feasibility of such tasks in individuals with mild to moderate neurological deficits [30,32,55].…”

Section: Discussionsupporting

confidence: 83%

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Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals

Kanzler

Schwarz

Held

et al. 2020

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Background.Assessing arm and hand sensorimotor impairments that are functionally relevant is essential to optimize the impact of neurorehabilitation interventions. Technology-aided assessments should provide a sensitive and objective characterization of upper limb impairments, but often provide arm weight support and neglect the importance of the hand, thereby questioning their functional relevance. The Virtual Peg Insertion Test (VPIT) addresses these limitations by quantifying arm movements and grip forces during a goal-directed manipulation task without arm weight support. The aim of this work was to evaluate the potential and robustness of the VPIT metrics to inform on sensorimotor impairments in arm and hand, and especially identify the functional relevance of the detected impairments. Methods.Arm and hand sensorimotor impairments were systematically characterized in 30 chronic stroke patients using conventional clinical scales and the VPIT. For the latter, ten previously established kinematic and kinetic core metrics were extracted and compared to conventional clinical scales of impairment and activity limitations. Additionally, the robustness of the VPIT metrics was investigated by analyzing their clinimetric properties (test-retest reliability, measurement error, and learning effects). Results.Twenty-three of the participants, the ones with mild to moderate sensorimotor impairments and without strong cognitive deficits, were able to successfully complete the VPIT protocol (duration 16.6 min). The VPIT metrics detected impairments in arm and hand in 90.0% of the participants, and were sensitive to increased muscle tone and pathological joint coupling. Most importantly, moderate to high significant correlations between conventional scales of activity limitations and the VPIT metrics were found, thereby indicating their functional relevance when grasping and transporting lightweight objects as well as dexterous finger manipulations. Lastly, the robustness of three out of the ten VPIT core metrics in post-stroke individuals was confirmed. Conclusions.This work provides evidence that technology-aided assessments requiring goal-directed manipulations without arm weight support can provide an objective, robust, and clinically feasible way to assess functionally relevant sensorimotor impairments in arm and hand in chronic poststroke individuals with mild to moderate deficits. This allows better identifying impairments with high functional relevance and can contribute to optimizing the functional benefits of neurorehabilitation interventions.Retrospectively registered: clinicaltrials.gov/ct2/show/NCT03135093 2

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Section: Discussionsupporting

confidence: 83%

“…FMA-UE scores for the most affected and less affected sides were 49 [32,40,57,61] and 65 [56,63,66,66], respectively. ARAT scores for the most affected and less affected sides were 47 [30,39,55,57] and 57 [45,57,57,57] , respectively. Detailed subject characteristics can be found in Table SM4.…”

Section: Resultsmentioning

confidence: 98%

Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals

Kanzler

Schwarz

Held

et al. 2020

Preprint

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“…These outcomes are calculated automatically, and gathering such quantitative performance data provides an opportunity to perform indepth post hoc analyses of performance patterns. For example, it is possible to gain insights about whether manual dexterity abnormalities are related to grasping, transporting, or releasing [21]. In a prospective clinical validation study that enrolled 51 patients with MS and 49 healthy individuals, data captured with the MSPT app compared favorably with those captured by technicians, and patients reported a high level of acceptance of the tool [20].…”

Section: Screening and Assessmentmentioning

confidence: 99%

Ehealth Solutions in Multiple Sclerosis: Use of Digital and Remote Communication Technologies

Marziniak¹,

Brichetto²,

Feys³

et al. 2017

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“…The feasibility of the VPIT has been successfully tested in pilot studies with healthy subjects 23 and neurological patients. 22,[24][25][26] However, a computational framework providing a complete and objective assessment of sensorimotor profiles based on kinematic and kinetic data still needs to be defined.…”

Section: Introductionmentioning

confidence: 99%

An Objective Technology-based Assessment of Arm and Hand Sensorimotor Disability in Neurological Disorders

Kanzler¹,

Rinderknecht²,

Schwarz

et al. 2019

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Background. Detailed assessments of upper limb disability are essential to understand and monitor sensorimotor recovery. Usually, multiple timeconsuming assessments are required to define a holistic sensorimotor profile of proximal (shoulder-elbow) and distal (wrist-hand) impairments and their impact on the capacity to perform activities. We propose and evaluate a novel physiologically-motivated computational framework for objectively assessing sensorimotor profiles in neurological patients using a single, rapid technologybased assessment involving goal-directed arm and hand movements. Methods.The Virtual Peg Insertion Test (VPIT) was administered to 121 healthy and 80 neurological subjects. The framework provides 25 kinematic and kinetic metrics expected to describe 12 sensorimotor components representative of ataxia and paresis and their influence on task performance, as well as one overall disability measure. The feasibility (protocol duration), structural validity (factor analysis and correlations ρ between sensorimotor components), concurrent validity (correlation with Action Research Arm Test; ARAT), and discriminant validity (comparing healthy controls and patients, and patients with different disability levels) were evaluated. Results. The median VPIT protocol duration was 16.5min in neurological patients. The sensor-based metrics could unambiguously be grouped into 12 mostly independent (median |ρ|=0.14) components. Ten components showed significant differences between healthy and impaired subjects and nine components indicated clear trends across disability levels, without any ceiling effects. The VPIT overall disability measure Technology-based Upper Limb Disability Assessment and ARAT were moderately correlated (ρ=−0.53, p<0.001). Conclusions. This work demonstrates the possibility to rapidly, holistically, and objectively assess proximal and distal sensorimotor impairments and their influence on the capacity to perform activities with a single assessment.

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Assessment of upper limb motor function in patients with multiple sclerosis using the Virtual Peg Insertion Test: A pilot study

Cited by 31 publications

References 23 publications

Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals

Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals

Ehealth Solutions in Multiple Sclerosis: Use of Digital and Remote Communication Technologies

An Objective Technology-based Assessment of Arm and Hand Sensorimotor Disability in Neurological Disorders

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