Centre for Neuroscience Studies , Queen's University, Kingston, Ontario, Canada.
Alcohol Clin Exp Res. 2014 Jan;38(1):116-25. doi: 10.1111/acer.12225. Epub 2013 Aug 5.
Fetal alcohol spectrum disorder (FASD) is associated with a large number of cognitive and sensory-motor deficits. In particular, the accurate assessment of sensory-motor deficits in children with FASD is not always simple and relies on clinical assessment tools that may be coarse and subjective. Here we present a new approach: using robotic technology to accurately and objectively assess motor deficits of children with FASD in a center-out reaching task.
A total of 152 typically developing children and 31 children with FASD, all aged between 5 and 18 were assessed using a robotic exoskeleton device coupled with a virtual reality projection system. Children made reaching movements to 8 peripheral targets in a random order. Reach trajectories were subsequently analyzed to extract 12 parameters that had been previously determined to be good descriptors of a reaching movement, and these parameters were compared for each child with FASD to a normative model derived from the performance of the typically developing population.
Compared with typically developing children, the children with FASD were found to be significantly impaired on most of the parameters measured, with the greatest deficits found in initial movement direction error. Also, children with FASD tended to fail more parameters than typically developing children: 95% of typically developing children failed fewer than 3 parameters compared with 69% of children with FASD. These results were particularly pronounced for younger children.
The current study has shown that robotic technology is a sensitive and powerful tool that provides increased specificity regarding the type of motor problems exhibited by children with FASD. The high frequency of motor deficits in children with FASD suggests that interventions aimed at stimulating and/or improving motor development should routinely be considered for this population.
胎儿酒精谱系障碍（FASD）与大量认知和感觉运动缺陷有关。特别是，准确评估 FASD 儿童的感觉运动缺陷并不总是简单的，并且依赖于可能粗糙和主观的临床评估工具。在这里，我们提出了一种新方法：使用机器人技术在中心向外伸手任务中准确客观地评估 FASD 儿童的运动缺陷。
共有 152 名正常发育的儿童和 31 名 FASD 儿童，年龄在 5 至 18 岁之间，使用与虚拟现实投影系统耦合的机器人外骨骼设备进行评估。儿童以随机顺序进行 8 个外围目标的伸手运动。随后分析到达轨迹以提取 12 个先前确定为良好描述到达运动的参数，并且将每个 FASD 儿童的这些参数与从正常发育人群的表现得出的规范模型进行比较。
与正常发育的儿童相比，FASD 儿童在大多数测量的参数上明显受损，最大的缺陷出现在初始运动方向误差中。此外，与正常发育的儿童相比，FASD 儿童更容易失败更多的参数：95%的正常发育儿童失败的参数少于 3 个，而 69%的 FASD 儿童失败的参数多于 3 个。这些结果对于年龄较小的儿童尤为明显。
目前的研究表明，机器人技术是一种敏感而强大的工具，它提供了有关 FASD 儿童表现出的运动问题类型的更高特异性。FASD 儿童的运动缺陷频率较高，表明应常规考虑针对该人群的刺激和/或改善运动发育的干预措施。
