Potential of robots as next-generation technology for clinical assessment of neurological disorders and upper-limb therapy

Scott, Stephen H.; Dukelow, Sean P.

doi:10.1682/jrrd.2010.04.0057

Cited by 162 publications

(120 citation statements)

References 104 publications

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“…13 Objective, quantitative, and sensitive measures should allow for a more accurate identification of impairments. In turn, this could allow for better tailoring of interventions to the individual and, ultimately, improved outcomes.…”

Section: Robotic Quantification Of Kinesthesiamentioning

confidence: 99%

“…Work from many groups has shown much promise for stroke rehabilitation through robotics. [9][10][11][12][13] As well, a growing area of research is the use of robotic tools to quantify sensorimotor dysfunction poststroke. 4,[14][15][16] Robotics promise increased precision and accuracy of measurement, in addition to better reliability compared with standardized observer-based ordinal scales.…”

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confidence: 99%

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Robotic Identification of Kinesthetic Deficits After Stroke

Semrau

Herter

Scott

et al. 2013

Stroke

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Background and Purpose-Kinesthesia, the sense of body motion, is essential to proper control and execution of movement.Despite its importance for activities of daily living, no current clinical measures can objectively measure kinesthetic deficits. The goal of this study was to use robotic technology to quantify prevalence and severity of kinesthetic deficits of the upper limb poststroke. Methods-Seventy-four neurologically intact subjects and 113 subjects with stroke (62 left-affected, 51 right-affected) performed a robot-based kinesthetic matching task with vision occluded. The robot moved the most affected arm at a preset speed, direction, and magnitude. Subjects were instructed to mirror-match the movement with their opposite arm (active arm). Results-A large number of subjects with stroke were significantly impaired on measures of kinesthesia. We observed impairments in ability to match movement direction (69% and 49% impaired for left-and right-affected subjects, respectively) and movement magnitude (42% and 31%). We observed impairments to match movement speed (32% and 27%) and increased response latencies (48% and 20%). Movement direction errors and response latencies were related to clinical measures of function, motor recovery, and dexterity. Conclusions-Using a robotic approach, we found that 61% of acute stroke survivors (n=69) had kinesthetic deficits.Additionally, these deficits were highly related to existing clinical measures, suggesting the importance of kinesthesia in day-to-day function. Our methods allow for more sensitive, accurate, and objective identification of kinesthetic deficits after stroke. With this information, we can better inform clinical treatment strategies to improve poststroke rehabilitative care and outcomes.

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Section: Robotic Quantification Of Kinesthesiamentioning

confidence: 99%

mentioning

confidence: 99%

Robotic Identification of Kinesthetic Deficits After Stroke

Semrau

Herter

Scott

et al. 2013

Stroke

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123

177

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“…1,2,9,12 These have been criticized for problems with ceiling effects 18 or issues with reliability. 19 However, more recently, robotics have shown to be a powerful measurement tool 14,15,[20][21][22][23] for determining when impairment returns to normal using continuous performance metrics that allow for comparison of poststroke performance with neurologically intact humans.…”

mentioning

confidence: 99%

Examining Differences in Patterns of Sensory and Motor Recovery After Stroke With Robotics

Semrau

Herter

Scott

et al. 2015

Stroke

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109

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Background and Purpose-Developing a better understanding of the trajectory and timing of stroke recovery is critical for developing patient-centered rehabilitation approaches. Here, we quantified proprioceptive and motor deficits using robotic technology during the first 6 months post stroke to characterize timing and patterns in recovery. We also make comparisons of robotic assessments to traditional clinical measures. Methods-One hundred sixteen subjects with unilateral stroke were studied at 4 time points: 1, 6, 12, and 26 weeks post stroke. Subjects performed robotic assessments of proprioceptive (position sense and kinesthesia) and motor function (unilateral reaching task and bimanual object hit task), as well as several clinical measures (Functional Independence Measure, Purdue Pegboard, and Chedoke-McMaster Stroke Assessment). Results-One week post stroke, many subjects displayed proprioceptive (48% position sense and 68% kinesthesia) and motor impairments (80% unilateral reaching and 85% bilateral movement). Interindividual recovery on robotic measures was highly variable. However, we characterized recovery as early (normal by 6 weeks post stroke), late (normal by 26 weeks post stroke), or incomplete (impaired at 26 weeks post stroke). Proprioceptive and motor recovery often followed different timelines. Across all time points, robotic measures were correlated with clinical measures. Conclusions-These results highlight the need for more sensitive, targeted identification of sensory and motor deficits to optimize rehabilitation after stroke. Furthermore, the trajectory of recovery for some individuals with mild to moderate stroke may be much longer than previously considered.

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“…We assessed the subjects upper limb sensory and motor function using the KINARM bilateral exoskeleton robot (BKIN Technologies Ltd, Kingston, ON, Canada), a robotic device that provides gravitational support of the arms, permits movements in the horizontal plane, monitors shoulder and elbow motion, and if required can move the arm in the workspace [7,8]. The augmented reality system of the KINARM superimposes computer-generated visual targets in the same plane as the subjects' arms.…”

Section: Robotic Assessmentmentioning

confidence: 99%