Objective measurement of synergistic movement patterns of the upper extremity following stroke: An explorative study

Abstract

The majority of stroke survivors have to cope with deficits in arm function, which is often monitored with subjective clinical scales during stroke rehabilitation. The aim of this study is to examine whether robotic outcome measures obtained during circle drawing are suitable to objectively measure upper extremity function of stroke survivors, especially regarding synergistic movement patterns. Stroke survivors (n = 16) and healthy subjects (n = 20) drew circles, as big and as round as possible, above a table top. Joint angles and positions of the shoulder and elbow were measured. Synergistic movement patterns were identified based on simultaneous changes of the shoulder elevation angle and elbow angle. Stroke survivors moved significantly more within synergistic movement patterns, compared to healthy subjects. Strong correlations between the proximal upper extremity part of the Fugl-Meyer (FM) scale and the use of synergistic movement patterns were found. The proposed outcome measures seem to be suitable measures to objectively quantify the occurrence of synergistic movement patterns of the upper extremity following stroke.

Effects of prolonged robot-assisted training on upper limb motor recovery in subacute stroke

“…Mirbagheri and Rymer (2008) showed that changes in elbow kinematics followed a similar pat-tern to that of clinical recovery evaluated using the Fugl-Meyer Assessment. However, other authors (Zollo et al, 2011) showed that kinematic measures were only moderately correlated with Fugl-Meyer scores, particularly with the proximal part of the FMA upper extremity scores (Krabben, Prange, Molier, Rietman, & Buurke, 2011;Subramanian, Yamanaka, Chilingaryan, & Levin, 2010). Our results suggest that end-effector robots may not be so appropriate to measure metrics related to motor recovery beyond the very first weeks post stroke.…”

Revisiting interhemispheric imbalance in chronic stroke: A tDCS study

“…Coordination of proximal and distal musculature is essential for functional movements with the upper limb. Circle drawing metrics have been used to investigate abnormal synergistic movement patterns that can develop after stroke (Dipietro et al, 2007, Krabben et al, 2011a, Krabben et al, 2011b. The neurophysiological after-effects of tDCS were examined using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation.…”

Component-Level Tuning of Kinematic Features From Composite Therapist Impressions of Movement Quality

“…Rehabilitation robotics has gained a lot of attention in quantification of motor functionality due to its ability to offer objective and repeatable therapy treatment [32]–[38]. Linear regression model-based kinematic scales were developed using the MIT-Manus robot to achieve highly a repeatable and high resolution framework for quantification of motor performance [39].…”