Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

Mang, Cameron S.; Whitten, Tara A.; Cosh, Madeline S; Scott, Stephen H.; Wiley, J. Preston; Debert, Chantel T.; Dukelow, Sean P.; Benson, Brian W.

doi:10.1371/journal.pone.0196205

Cited by 22 publications

(23 citation statements)

References 43 publications

(83 reference statements)

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“…Demonstrating the reliability of the proprioception assessment (gauge position matching task) is an important contribution, since it is a long-standing challenge to reliably evaluate proprioceptive hand impairments in neurological patients, using either conventional or robotic methods [23,35]. In addition, the reliability results obtained for the motor and sensorimotor task are in line with the ones previously reported in literature (ICC 0.7-0.9 for metrics of good quality) [11,[71][72][73], although it is challenging to directly compare these, as some studies were performed with control subjects instead of the target population. Compared to conventional clinical assessments, the proposed robotic assessments generally result in higher measurement error (e.g.…”

Section: Test-retest Reliabilitysupporting

confidence: 81%

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Zbytniewska

Kanzler

Jordan

et al. 2020

Preprint

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Background: Neurological injuries such as stroke often differentially impair hand motor and somatosensory function, as well as the interplay between the two, which leads to limitations in performing activities of daily living. However, it is challenging to identify which specific aspects of sensorimotor function are impaired based on conventional clinical assessments that are often insensitive and subjective. In this work we propose and validate a set of robot-assisted assessments aiming at disentangling hand proprioceptive from motor impairments, and capturing their interrelation (sensorimotor impairments). Methods: For this purpose, a battery of five complementary assessment tasks was implemented on a one degree-of-freedom end-effector robotic platform acting on the index finger metacarpophalangeal joint. Specifically, proprioceptive impairments were assessed using a position matching paradigm. Fast target reaching, range of motion and maximum fingertip force tasks characterized motor function deficits. Finally, sensorimotor impairments were assessed using a dexterous trajectory following task. Clinical feasibility (duration), reliability (intra-class correlation coefficient ICC, smallest real difference SRD) and validity (Kruskal-Wallis test, Spearman correlations rho) of these tasks were evaluated with 36 sub-acute stroke subjects and 31 age-matched neurologically intact controls. Results: Eighty-three percent of stroke survivors with varied impairment severity (mild to severe) could complete all robotic tasks (duration: <15 min per tested hand). Further, the study demonstrated good to excellent reliability of the robotic tasks in the stroke population (ICC>0.7, SRD<30%), as well as discriminant validity, as indicated by significant differences (p-value<0.001) between stroke and control subjects on all metrics extracted from the robotic tasks. Concurrent validity was shown through moderate to strong correlations (rho=0.4-0.8) between the robotic outcome measures and clinical scales. Finally, robotic tasks targeting different deficits were not strongly correlated, thereby presenting complementary information about a patient’s impairment profile. Conclusions: The proposed robot-assisted assessments provide a clinically feasible, reliable, and valid approach to distinctly characterize impairments in hand proprioceptive and motor function, along with the interaction between the two. This opens new avenues to help unravel the contributions of unique aspects of sensorimotor function in post-stroke recovery, as well as to contribute to future developments towards personalized, assessment-driven therapies.

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Section: Test-retest Reliabilitysupporting

confidence: 81%

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Zbytniewska

Kanzler

Jordan

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…A criticism of our work is that changes in performance over time could reflect either “true” recovery, a learning effect, or a combination of both. In a large cohort of healthy young adults using the same robotic tasks as in the present study, learning effects were only observed in 3 parameters of the OH task (total hits, hits with the dominant hand, and median error) 47. Thus, we expect that the impact of any learning effects in the present study were likely minimal.…”

Section: Discussionmentioning

confidence: 53%

Differential Impact of Acute Lesions Versus White Matter Hyperintensities on Stroke Recovery

Hawe

Findlater

Kenzie

et al. 2018

JAHA

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BackgroundUnderstanding how the size of acute lesions and white matter hyperintensities (WMH) impact stroke recovery can improve our ability to predict outcomes and tailor treatments. The aim of this exploratory study was to investigate the role of acute lesion volume and WMH volume on longitudinal recovery of specific sensory, motor, and cognitive impairments after stroke using robotic and clinical measures.Methods and ResultsEighty‐two individuals were assessed at 1, 6, 12, and 26 weeks poststroke with robotic tasks and commonly used clinical measures. The volumes of acute lesions and WMH were measured on fluid‐attenuated inversion recovery images. Linear mixed models were used to investigate the role of acute lesions and WMH on parameters derived from the robotic tasks and clinical measures. Regression analysis determined the added value of acute lesion and WMH volumes along with measures of initial performance to predict outcomes at 6 months. Acute lesion volume has widespread effects on sensory, motor, and overall functional recovery poststroke. The impact of WMH was specific to cognitive impairments. Apart from the robotic position sense task, neither lesion volume nor WMH measure had significant ability to predict outcomes at 6 months over using initial impairment as measured by robotic assessments alone.ConclusionsWhile acute lesion volume and WMH may impact different impairments poststroke, their clinical utility in predicting outcomes at 6 months poststroke is limited.

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“…It has been used to characterize deficits in a variety of clinical populations such as stroke ( [14][15][16]), ALS [17], Parkinson's disease [18], TIA [19], and concussion [20]. Furthermore, previous work has highlighted the test-retest reliability of Kinarm assessment results [21]. Here, we will investigate the feasibility of using Kinarm to quantify deficits on behavioral tasks in patients with a variety of epilepsy subtypes.…”

Section: Introductionmentioning

confidence: 99%

Assessing various sensorimotor and cognitive functions in people with epilepsy is feasible with robotics

Simmatis

Jin

Keiski

et al. 2020

Epilepsy & Behavior

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Background: Epilepsy is a common neurological disorder characterized by recurrent seizures, along with comorbid cognitive and psychosocial impairment. Current gold standards of assessment can quantify cognitive and motor performance, but may not capture all subtleties of behavior. Here, we study the feasibility of assessing various upper limb sensorimotor and cognition functions in people with epilepsy using the Kinarm robotic assessment system. We quantify performance across multiple behavioral domains and additionally consider the possible effects of epilepsy subtype and medication. Methods: We recruited individuals with a variety of epilepsy subtypes. Participants performed 8 behavioral tasks that tested motor, cognitive, and sensory domains. We collected data on the same tasks from a group of control participants that had no known neurological impairments. We quantified performance using Task Scores, which provide a composite measure of overall performance on a given task and are adjusted for age, sex, and handedness. Results: We collected data from 46 individuals with epilepsy and 92 control participants. The assessment was well-tolerated, with no adverse events recorded. Cognitive tasks testing spatial working memory, executive function, and motor response inhibition were the most frequently impaired in the epilepsy cohort, with 33/46 (72%) being outside the normal range on at least one of these tasks. Additionally, 29/46 (63%) were impaired on at least one task testing primarily motor skill, and 14/46 (30%) were impaired on a proprioceptive sensory task. People with either focal epilepsy or generalized epilepsy performed significantly worse on both motor and cognitive tasks than control participants after correcting for multiple comparisons. There were no statistical differences between generalized and focal epilepsy groups on Task Scores. Finally, individuals taking topiramate trended toward having worse performance on a spatial working memory task than other individuals with epilepsy who were not taking topiramate. Conclusions: Kinarm robotic assessment is feasible in individuals with epilepsy and is well-tolerated. Our robotic paradigm can detect impairments in various sensorimotor and cognitive functions across the population with epilepsy. Future studies will explore the role of epilepsy subtype and medications.

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Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

Cited by 22 publications

References 43 publications

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Differential Impact of Acute Lesions Versus White Matter Hyperintensities on Stroke Recovery

Assessing various sensorimotor and cognitive functions in people with epilepsy is feasible with robotics

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