Assessment of upper-limb sensorimotor function of subacute stroke patients using visually guided reaching.
OBJECTIVE
Using robotic technology, we examined the ability of a visually guided reaching task to assess the sensorimotor function of patients with stroke.


METHODS
Ninety-one healthy participants and 52 with subacute stroke of mild to moderate severity (26 with left- and 26 with right-affected body sides) performed an unassisted reaching task using the KINARM robot. Each participant was assessed using 12 movement parameters that were grouped into 5 attributes of sensorimotor control.


RESULTS
A number of movement parameters individually identified a large number of stroke participants as being different from 95% of the controls-most notably initial direction error, which identified 81% of left-affected patients. We also found interlimb differences in performance between the arms of those with stroke compared with controls. For example, whereas only 31% of left-affected participants showed differences in reaction time with their affected arm, 54% showed abnormal interlimb differences in reaction time. Good interrater reliability (r > 0.7) was observed for 9 of the 12 movement parameters. Finally, many stroke patients deemed impaired on the reaching task had been scored 6 or less on the arm portion of the Chedoke-McMaster Stroke Assessment Scale, but some who scored a normal 7 were also deemed impaired in reaching.


CONCLUSIONS
Robotic technology using a visually guided reaching task can provide reliable information with greater sensitivity about a patient's sensorimotor impairments following stroke than a standard clinical assessment scale.
Queen's University, Kingston, ON, Canada.
Angela M
AM
Coderre
Amr Abou
AA
Zeid
Sean P
SP
Dukelow
Melanie J
MJ
Demmer
Kimberly D
KD
Moore
Mary Jo
MJ
Demers
Helen
H
Bretzke
Troy M
TM
Herter
Janice I
JI
Glasgow
Kathleen E
KE
Norman
Stephen D
SD
Bagg
Stephen H
SH
Scott
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000294:innervation / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis* / Q000503:physiopathology; D010291:Paresis / Q000175:diagnosis* / Q000503:physiopathology; D011597:Psychomotor Performance / Q000502:physiology*; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult