Li Kuan-yi, Lin Keh-chung, Chen Chih-kuang, Liing Rong-jiuan, Wu Ching-yi, Chang Wan-ying
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Arch Phys Med Rehabil. 2015 Sep;96(9):1666-75. doi: 10.1016/j.apmr.2015.04.013. Epub 2015 May 1.
To examine the concurrent and predictive validity of measurements of kinematic variables during reaching tasks with and without a trunk constraint in individuals with stroke.
Randomized controlled trials.
Hospitals and a laboratory.
Individuals with stroke (N=95) enrolled in previous and ongoing clinical trials.
Upper limb training protocols were 90 to 120 minutes of intervention every weekday for 3 to 4 weeks.
Functional capacity was assessed using the Action Research Arm Test and motor impairment using the Fugl-Meyer Assessment for the Upper Extremity. Movement kinematics were measured during a reaching task with and without a trunk constraint. We derived 5 endpoint control variables and 3 joint recruitment variables for estimating concurrent and predictive validity.
The adjusted R(2) values for the constraint tasks ranged from .24 to .38 and for the unconstraint tasks from .29 to .40. Movement time was the most prominent kinematic variable for the Fugl-Meyer Assessment for the Upper Extremity before and after the intervention (P<.05). For the Action Research Arm Test, movement time and endpoint displacement were the most significant variables before and after the intervention, respectively (P<.05).
Measuring kinematic performance during an unconstrained task is appropriate and possibly sufficient to represent motor impairment and functional capacity of individuals with stroke. Movement time is the dominant variable associated with motor impairment and functional capacity, and endpoint displacement is unique in reflecting functional capacity of individuals with stroke.
研究在有或没有躯干限制的情况下，中风患者在伸手任务中运动学变量测量的同时效度和预测效度。
随机对照试验。
医院和实验室。
纳入既往及正在进行的临床试验中的中风患者（N = 95）。
上肢训练方案为每周工作日进行90至120分钟的干预，持续3至4周。
使用动作研究臂试验评估功能能力，使用上肢Fugl - Meyer评估法评估运动障碍。在有和没有躯干限制的伸手任务中测量运动运动学。我们推导了5个终点控制变量和3个关节募集变量，以估计同时效度和预测效度。
受限任务的调整后R²值范围为0.24至0.38，无限制任务的调整后R²值范围为0.29至0.40。干预前后，运动时间是上肢Fugl - Meyer评估中最突出的运动学变量（P < 0.05）。对于动作研究臂试验，干预前后运动时间和终点位移分别是最显著的变量（P < 0.05）。
在无限制任务中测量运动学表现适用于代表中风患者的运动障碍和功能能力，可能也是足够的。运动时间是与运动障碍和功能能力相关的主要变量，终点位移在反映中风患者的功能能力方面具有独特性。
