The modified drawing test for assessment of arm movement quality

Abstract

The cerebrovascular accident often results in motor impairment of one of the upper limbs, hence, compromising the quality of life of stroke survivors. Rehabilitation aims to restore the movement abilities of the paralyzed/paretic upper limb. An important element in rehabilitation is to apply a quantified measure of the quality of movement, in order to follow the recovery and select the most appropriate therapeutic modality. We developed a method that uses data recorded during planar movements and outputs an objective measure that relates to the smoothness, velocity and precision of the movement. This method is universal, in a sense that hand position can be recorded by any available means (e.g., robot assistant, digitizing board, motion tracking systems, etc). The method follows the Drawing Test, but generates results that show the ability of the patient to make point to point movements and track the presented trajectory. The method is based on measurements of hand position during movement along a target path in form of a 2 cm wide rectangle. The patient’s task is to move the hand along the target path as quickly as possible, with as few contacts (collisions) with the sides of the path. This paper addresses the aspects of automatic detection of parameters that quantify the quality of movement (speed, smoothness and precision). The use of this method is presented with 10 patients. [Projekat Ministarstva nauke Republike Srbije, br. 175016

Feedback-Mediated Upper Extremities Exercise: Increasing Patient Motivation in Poststroke Rehabilitation

“…Movements performed during mDT were analyzed with the following parameters.

Speed was calculated as the ratio of path length and time spent to complete the task.

Precision was estimated based on the quantity of the drawing outside of the square template. This procedure is described in detail by Kostić and Popović [29].

Smoothness was calculated based on characteristics of the velocity curve and jerk (third derivative of position), as described in [29].

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“…mDT was done at entry into therapy (baseline) and after intervention. In the mDT, participants were instructed to draw a square shape, based on the template appropriate for the patient's WS, as fast and as precise as possible, three times, and with a short pause in between [ 29 , 30 ]. The best out of three performances, evaluated by minimizing criterion function for both speed and precision, was analyzed.…”

“…Speed and precision were chosen as inherent to the test, while smoothness is a proven indicator of rehabilitation progress [ 31 , 32 ]. These measures are presented in detail in [ 29 ].…”

“… Precision was estimated based on the quantity of the drawing outside of the square template. This procedure is described in detail by Kostić and Popović [ 29 ]. Smoothness was calculated based on characteristics of the velocity curve and jerk (third derivative of position), as described in [ 29 ].…”

Serious Games for Assessment and Training in Post-stroke Robotic Upper-limb Telerehabilitation

“…All patients will be assessed at the beginning and the end of the program. The Fugl-Meyer Assessment (Sanford et al, 1993), the Action Research Arm Test (Van der Lee et al, 2001), the Barthel index (Collin et al, 1988), the Modified Rankin scale (De Haan et al, 1995), the Beck depression scale (Beck et al, 1961), the Wolf Motor Function test (Wolf et al, 2001) and the Modified Drawing Test (Kostić et al, 2013) are among the measurements used. In addition, an experimental psychologist interviews patients to evaluate comfort, pain, fatigue, enjoyment, benefits, desire to continue, and motivation to exercise.…”