Nordin Nurdiana, Xie Sheng Quan, Wünsche Burkhard
Department of Mechanical Engineering, The University of Auckland, 20 Symonds Street, Auckland, New Zealand.
J Neuroeng Rehabil. 2014 Sep 12;11:137. doi: 10.1186/1743-0003-11-137.
: Studies of stroke patients undergoing robot-assisted rehabilitation have revealed various kinematic parameters describing movement quality of the upper limb. However, due to the different level of stroke impairment and different assessment criteria and interventions, the evaluation of the effectiveness of rehabilitation program is undermined. This paper presents a systematic review of kinematic assessments of movement quality of the upper limb and identifies the suitable parameters describing impairments in stroke patients. A total of 41 different clinical and pilot studies on different phases of stroke recovery utilizing kinematic parameters are evaluated. Kinematic parameters describing movement accuracy are mostly reported for chronic patients with statistically significant outcomes and correlate strongly with clinical assessments. Meanwhile, parameters describing feed-forward sensorimotor control are the most frequently reported in studies on sub-acute patients with significant outcomes albeit without correlation to any clinical assessments. However, lack of measures in coordinated movement and proximal component of upper limb enunciate the difficulties to distinguish the exploitation of joint redundancies exhibited by stroke patients in completing the movement. A further study on overall measures of coordinated movement is recommended.
对接受机器人辅助康复治疗的中风患者的研究揭示了各种描述上肢运动质量的运动学参数。然而,由于中风损伤程度不同、评估标准和干预措施不同,康复计划效果的评估受到了影响。本文对上肢运动质量的运动学评估进行了系统综述,并确定了描述中风患者损伤的合适参数。共评估了41项利用运动学参数对中风恢复不同阶段进行的不同临床和试点研究。描述运动准确性的运动学参数大多在慢性患者中报告,结果具有统计学意义,且与临床评估密切相关。同时,描述前馈感觉运动控制的参数在亚急性患者的研究中报告最为频繁,结果显著,尽管与任何临床评估均无关联。然而,在上肢协调运动和近端部分缺乏测量方法,这表明难以区分中风患者在完成运动时所表现出的关节冗余利用情况。建议进一步研究协调运动的整体测量方法。