[Abstract] A clinically feasible kinematic assessment method of upper extremity motor function impairment after stroke

Abstract

The development of feasible kinematic assessment methods of upper extremity motor function impairment after stroke is clinically extremely important in physiotherapy and rehabilitation engineering. Microsoft Kinect has a potential of a low-cost and compact solution for clinical based assessment of the upper limb motor function after stroke. However, the reliability of Microsoft Kinect in the upper limb motor function assessment has not been well established. Therefore, there is a hesitation in usage of Microsoft Kinect for clinical applications. It is expected that any measurement procedure has the capability to differentiate between pathological and normal performance. On the other hand, the identification of the kinematic metrics that best evaluate impairment of upper-extremity motor function is a key problem of any measurement protocol. Primary objective of our study is, by differentiating pathological performance from the healthy performance and identifying the kinematic metrics that best evaluate the impairment, to demonstrate the robustness/usability of Microsoft Kinect in kinematic analysis of motor performance of stroke patients. We compared the kinematic metrics of the forward reaching movement obtained data recorded from Microsoft Kinect between three stroke patients and two healthy subjects based on the Principal Component Analysis (PCA). In the study, we have defined a new inter-joint coordination index (IJCI) based on PCA to capture inter-joint coordination dynamic of reaching movement in addition to other metrics those have been previously defined and used in literature to quantify upper limb impairment. We observed that the IJCI has significant importance to detect impairment of upper-extremity motor function during a forward reaching task and to discriminate stroke patients from healthy controls.

We hope that this paper will promote the acceptance of objective kinematic analysis into routine rehabilitation practices.

Source: A clinically feasible kinematic assessment method of upper extremity motor function impairment after stroke

[ARTICLE] Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients

Upper-limb impairment after stroke is caused by weakness, loss of individual joint control, spasticity and abnormal synergies. Upper limb movement frequently involves abnormal, stereotyped and fixed synergies, likely related to the increased use of subcortical networks following the stroke. The flexible coordination of the shoulder and elbow joints is also disrupted. New methods for motor learning, based on the stimulation of activity-dependent neural plasticity have been developed. These include robots that can adaptively assist active movements and generate many movement repetitions. However, most of these robots only control the movement of the hand in space. The aim of the present text is to analyse the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination. Firstly, a review of studies on upper-limb coordination in stroke patients is presented and the potential for recovery of coordination is examined. Secondly, issues relating to the mechanical design of exoskeletons and the transmission of constraints between the robotic and human limbs are discussed. The third section considers the development of different methods to control exoskeletons: existing rehabilitation devices and approaches to the control and rehabilitation of joint coordinations are then reviewed, along with preliminary clinical results available. Finally, perspectives and future strategies for the design of control mechanisms for rehabilitation exoskeletons are discussed.

via Frontiers | Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients | Frontiers in Human Neuroscience.