Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
Calgary Stroke Program, Departments of Clinical Neurosciences, Radiology, Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
J Neuroeng Rehabil. 2017 Nov 13;14(1):114. doi: 10.1186/s12984-017-0329-8.
Proprioception is the sense of the position and movement of our limbs, and is vital for executing coordinated movements. Proprioceptive disorders are common following stroke, but clinical tests for measuring impairments in proprioception are simple ordinal scales that are unreliable and relatively crude. We developed and validated specific kinematic parameters to quantify proprioception and compared two common metrics, Euclidean and Mahalanobis distances, to combine these parameters into an overall summary score of proprioception.
We used the KINARM robotic exoskeleton to assess proprioception of the upper limb in subjects with stroke (N = 285. Mean days post-stroke = 12 ± 15). Two aspects of proprioception (position sense and kinesthetic sense) were tested using two mirror-matching tasks without vision. The tasks produced 12 parameters to quantify position sense and eight to quantify kinesthesia. The Euclidean and Mahalanobis distances of the z-scores for these parameters were computed each for position sense, kinesthetic sense, and overall proprioceptive function (average score of position and kinesthetic sense).
A high proportion of stroke subjects were impaired on position matching (57%), kinesthetic matching (65%), and overall proprioception (62%). Robotic tasks were significantly correlated with clinical measures of upper extremity proprioception, motor impairment, and overall functional independence. Composite scores derived from the Euclidean distance and Mahalanobis distance showed strong content validity as they were highly correlated (r = 0.97-0.99).
We have outlined a composite measure of upper extremity proprioception to provide a single continuous outcome measure of proprioceptive function for use in clinical trials of rehabilitation. Multiple aspects of proprioception including sense of position, direction, speed, and amplitude of movement were incorporated into this measure. Despite similarities in the scores obtained with these two distance metrics, the Mahalanobis distance was preferred.
本体感觉是我们四肢位置和运动的感觉，对于执行协调运动至关重要。本体感觉障碍在中风后很常见，但用于测量本体感觉障碍的临床测试是简单的序数量表，这些量表既不可靠又相对粗糙。我们开发并验证了特定的运动学参数来量化本体感觉，并比较了两种常用的度量标准，即欧几里得距离和马氏距离，将这些参数组合成本体感觉的总体综合评分。
我们使用 KINARM 机器人外骨骼来评估中风患者（N=285. 中风后平均天数为 12±15 天）的上肢本体感觉。使用两个没有视觉的镜像匹配任务来测试本体感觉的两个方面（位置感和运动感觉）。这些任务产生了 12 个参数来量化位置感和 8 个参数来量化运动感觉。计算这些参数的 z 分数的欧几里得距离和马氏距离，分别用于位置感、运动感觉和整体本体感觉功能（位置和运动感觉的平均得分）。
相当比例的中风患者在位置匹配（57%）、运动感觉匹配（65%）和整体本体感觉（62%）方面存在障碍。机器人任务与上肢本体感觉、运动障碍和整体功能独立性的临床测量有显著相关性。基于欧几里得距离和马氏距离得出的综合评分具有很强的内容有效性，因为它们高度相关（r=0.97-0.99）。
我们概述了一种上肢本体感觉的综合测量方法，为康复临床试验提供了一种单一的连续本体感觉功能测量方法。该测量方法纳入了本体感觉的多个方面，包括位置感、方向感、运动速度和运动幅度。尽管这两种距离度量标准的得分相似，但马氏距离更受青睐。
