Gyarmaty Jane E, Abiusi Francesca S, Hoffman Natalie B, Ibrahim Reem E, Linne Emily R, Matta Sanjana, Nissen Carli R, Sankaran Maya A, Smith Alexandrea M, Acosta Ana Maria, Ellis Michael D
Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL.
Northwestern University Interdepartmental Neuroscience, Chicago, IL.
Arch Rehabil Res Clin Transl. 2024 Nov 12;7(1):100385. doi: 10.1016/j.arrct.2024.100385. eCollection 2025 Mar.
To determine the test-retest reliability and minimal detectable change (MDC) scores for 7 precision measures examining upper extremity strength, reaching ability, and the expression of flexion synergy after stroke. The measurements relied on a mechatronic evaluation designed for time efficiency facilitating implementation in inpatient translational research.
Observational, analytical, cross-sectional study.
University research laboratory.
Twenty-five participants (N=25) >6 months poststroke with persistent upper extremity body function impairment and activity limitation were recruited using convenience sampling.
Not applicable.
Shoulder abduction and elbow extension strength measured as a unit of torque (Nm); normalized reaching distance with the arm under 3 conditions: supported, against gravity, and against 50% of shoulder abduction strength; flexion synergy takeover; and emergence thresholds.
Twelve male and 13 female participants aged 56.4 ± 17.8 years with a mean time poststroke of 5.37 ± 7.55 years completed the study. The intraclass correlation coefficients for the outcome measures were as follows: shoulder abduction strength (0.963), elbow extension strength (0.983), supported reaching (0.982), reaching against gravity (0.968), reaching against 50% abduction strength (0.974), flexion synergy takeover (0.919), and flexion synergy emergence (0.949) thresholds. The MDC, overall mean, and standard deviation were calculated as follows: shoulder abduction strength (5.69 Nm, 24.44±10.67 Nm), elbow extension strength (5.66 Nm, 18.53±15.66 Nm), supported reaching (0.07, 0.91±0.20), reaching against gravity (0.15, 0.73±0.30), reaching against 50% abduction strength (0.13, 0.69±0.29), flexion synergy takeover (0.14, 0.91±0.17), and flexion synergy emergence (0.17, 0.56±0.27) thresholds.
The mechatronic evaluation, although streamlined from more labor-intensive laboratory evaluations, demonstrates excellent (>0.90) test-retest reliability and MDC scores for 7 precision measures of upper extremity body function impairment (weakness and synergy) and activity limitation (reaching).
确定用于评估中风后上肢力量、伸展能力和屈曲协同运动表现的7项精准测量指标的重测信度和最小可检测变化（MDC）分数。这些测量依赖于一种为提高时间效率而设计的机电一体化评估方法，便于在住院患者的转化研究中实施。
观察性、分析性横断面研究。
大学研究实验室。
采用便利抽样法招募了25名中风后6个月以上、存在持续性上肢身体功能障碍和活动受限的参与者（N = 25）。
不适用。
肩外展和肘伸展力量，以扭矩单位（Nm）测量；在三种条件下测量手臂的标准化伸展距离：支撑状态、抗重力状态以及对抗50%肩外展力量状态；屈曲协同运动接管；以及出现阈值。
12名男性和13名女性参与者，年龄56.4±17.8岁，中风后平均时间为5.37±7.55年，完成了本研究。各观察指标的组内相关系数如下：肩外展力量（0.963）、肘伸展力量（0.983）、支撑状态下伸展（0.982）、抗重力伸展（0.968）、对抗50%外展力量伸展（0.974）、屈曲协同运动接管（0.919）以及屈曲协同运动出现（0.949）阈值。MDC、总体均值和标准差计算如下：肩外展力量（5.69 Nm，24.44±10.67 Nm）、肘伸展力量（5.66 Nm，18.53±15.66 Nm）、支撑状态下伸展（0.07，0.91±0.20）、抗重力伸展（0.15，0.73±0.30）、对抗50%外展力量伸展（0.13，0.69±0.29）、屈曲协同运动接管（0.14，0.91±0.17）以及屈曲协同运动出现（0.17，0.56±0.27）阈值。
尽管机电一体化评估方法比劳动强度更大的实验室评估方法更为简化，但对于上肢身体功能障碍（无力和协同运动）和活动受限（伸展）的7项精准测量指标，其重测信度和MDC分数均表现出色（>0.90）。
