Institute of Neuroscience, Université catholique de Louvain, BE-1200 Brussels, Belgium.
J Rehabil Med. 2014 Feb;46(2):117-25. doi: 10.2340/16501977-1245.
To validate a protocol assessing upper limb kinematics using a planar robot among stroke patients.
Prospective cohort study.
Age-matched healthy subjects (n = 25) and stroke patients (n = 25).
Various kinematic indices (n = 44) were obtained from 4 tasks performed by subjects with REAplan, a planar end-effector robotic device. The metrological properties of this protocol were studied.
In stroke patients, 43 kinematic indices showed moderate to excellent reliability (intraclass correlation coefficients (ICC) range 0.40-0.95; and minimal detectable changes range 9.9-121.1%). In healthy subjects, 25 kinematic indices showed moderate to excellent reliability (ICC range 0.40-0.91) and 3 indices showed a laterality effect (p < 0.05). Many of these indices (27 of 44) were altered in stroke patients in comparison with healthy subjects (p < 0.05). The Box and Block test (manual dexterity) and Upper Limb Sub-score of the Fugl-Meyer Assessment (motor control) showed moderate to good correlations with, respectively, 13 and 4 indices (r > 0.40). Finally, a principal component analysis allowed the elaboration of a short version of the protocol, reducing the number of indices to 5 (i.e. Amplitude, CVstraightness, Speed Metric, CVjerk metric and CVspeed metric).
This study provides a standardized, valid, reliable and sensitive protocol to quantify upper limb impairments in stroke patients, using a planar robot.
验证一种使用平面机器人评估脑卒中患者上肢运动学的方案。
前瞻性队列研究。
年龄匹配的健康受试者（n=25）和脑卒中患者（n=25）。
通过 REAplan 平面末端执行器机器人设备，对受试者进行 4 项任务，获得 44 种运动学指标。研究了该方案的计量学特性。
在脑卒中患者中，43 种运动学指标具有中等到极好的可靠性（组内相关系数（ICC）范围为 0.40-0.95；最小可检测变化范围为 9.9-121.1%）。在健康受试者中，25 种运动学指标具有中等到极好的可靠性（ICC 范围为 0.40-0.91），3 种指标具有侧偏效应（p<0.05）。与健康受试者相比，许多这些指标（44 个中的 27 个）在脑卒中患者中发生了改变（p<0.05）。箱式和木块测试（手灵巧度）和 Fugl-Meyer 评估的上肢子评分（运动控制）分别与 13 个和 4 个指标（r>0.40）具有中等到良好的相关性。最后，主成分分析允许制定方案的简化版本，将指标数量减少到 5 个（即幅度、直线度 CV、速度度量、CV 急动度度量和 CV 速度度量）。
本研究提供了一种使用平面机器人量化脑卒中患者上肢损伤的标准化、有效、可靠和敏感的方案。
