Euromov, University of Montpellier, Montpellier, France.
Physical Medicine and Rehabilitation, Montpellier University Hospital, Montpellier, France.
J Neuroeng Rehabil. 2018 Nov 14;15(1):104. doi: 10.1186/s12984-018-0451-2.
After a stroke, during seated reaching with their paretic upper limb, many patients spontaneously replace the use of their arm by trunk compensation movements, even though they are able to use their arm when forced to do so. We previously quantified this proximal arm non-use (PANU) with a motion capture system (Zebris, CMS20s). The aim of this study was to validate a low-cost Microsoft Kinect-based system against the CMS20s reference system to diagnose PANU.
In 19 hemiparetic stroke individuals, the PANU score, reach length, trunk length, and proximal arm use (PAU) were measured during seated reaching simultaneously by the Kinect (v2) and the CMS20s over two testing sessions separated by two hours.
Intraclass correlation coefficients (ICC) and linear regression analysis showed that the PANU score (ICC = 0.96, r = 0.92), reach length (ICC = 0.81, r = 0.68), trunk length (ICC = 0.97, r = 0.94) and PAU (ICC = 0.97, r = 0.94) measured using the Kinect were strongly related to those measured using the CMS20s. The PANU scores showed good test-retest reliability for both the Kinect (ICC = 0.76) and CMS20s (ICC = 0.72). Bland and Altman plots showed slightly reduced PANU scores in the re-test session for both systems (Kinect: - 4.25 ± 6.76; CMS20s: - 4.71 ± 7.88), which suggests a practice effect.
We showed that the Kinect could accurately and reliably assess PANU, reach length, trunk length and PAU during seated reaching in post stroke individuals. We conclude that the Kinect can offer a low-cost and widely available solution to clinically assess PANU for individualised rehabilitation and to monitor the progress of paretic arm recovery.
The study was approved by The Ethics Committee of Montpellier, France (N°ID-RCB: 2014-A00395-42) and registered in Clinical Trial (N° NCT02326688, Registered on 15 December 2014, https://clinicaltrials.gov/ct2/show/results/NCT02326688 ).
在脑卒中后，许多患者在进行坐位上肢伸展时会出现代偿性的躯干运动，即使被迫使用上肢，他们也会自发地改用躯干运动。我们之前使用运动捕捉系统（Zebris CMS20s）来量化这种近端上肢非使用（PANU）。本研究的目的是验证一种基于微软 Kinect 的低成本系统，以诊断脑卒中后患者的 PANU。
在 19 名偏瘫脑卒中患者中，使用 Kinect（v2）和 CMS20s 同时在两次测试中测量坐位伸展时的 PANU 评分、伸展长度、躯干长度和上肢近端使用（PAU），两次测试间隔两小时。
组内相关系数（ICC）和线性回归分析表明，使用 Kinect 测量的 PANU 评分（ICC=0.96，r=0.92）、伸展长度（ICC=0.81，r=0.68）、躯干长度（ICC=0.97，r=0.94）和 PAU（ICC=0.97，r=0.94）与使用 CMS20s 测量的结果高度相关。Kinect 的 PANU 评分具有良好的测试-重测信度（ICC=0.76），CMS20s 的 PANU 评分也具有良好的测试-重测信度（ICC=0.72）。Bland-Altman 图显示，两种系统在重测时的 PANU 评分均略有降低（Kinect：-4.25±6.76；CMS20s：-4.71±7.88），这表明存在练习效应。
我们表明，Kinect 可以准确可靠地评估脑卒中后个体坐位伸展时的 PANU、伸展长度、躯干长度和 PAU。我们得出结论，Kinect 可以为个体化康复提供一种低成本且广泛可用的解决方案，以评估 PANU，并监测偏瘫上肢恢复的进展。
该研究得到了法国蒙彼利埃伦理委员会的批准（编号：ID-RCB：2014-A00395-42），并在临床试验中注册（编号：NCT02326688，于 2014 年 12 月 15 日注册，https://clinicaltrials.gov/ct2/show/results/NCT02326688）。
