title: Circle drawing as evaluative movement task in stroke rehabilitation: an explorative study.
abstract: BACKGROUND
  The majority of stroke survivors have to cope with deficits in arm function, which is often measured with subjective clinical scales. The objective of this study is to examine whether circle drawing metrics are suitable objective outcome measures for measuring upper extremity function of stroke survivors.
  
  
  METHODS
  Stroke survivors (n = 16) and healthy subjects (n = 20) drew circles, as big and as round as possible, above a table top. Joint angles and positions were measured. Circle area and roundness were calculated, and synergistic movement patterns were identified based on simultaneous changes of the elevation angle and elbow angle.
  
  
  RESULTS
  Stroke survivors had statistically significant lower values for circle area, roundness and joint excursions, compared to healthy subjects. Stroke survivors moved significantly more within synergistic movement patterns, compared to healthy subjects. Strong correlations between the proximal upper extremity part of the Fugl-Meyer scale and circle area, roundness, joint excursions and the use of synergistic movement patterns were found.
  
  
  CONCLUSIONS
  The present study showed statistically significant differences in circle area, roundness and the use of synergistic movement patterns between healthy subjects and stroke survivors. These circle metrics are strongly correlated to stroke severity, as indicated by the proximal upper extremity part of the FM score.In clinical practice, circle area and roundness can give useful objective information regarding arm function of stroke survivors. In a research setting, outcome measures addressing the occurrence of synergistic movement patterns can help to increase understanding of mechanisms involved in restoration of post stroke upper extremity function.
authors: Roessingh Research and Development, Roessinghsbleekweg 33B, Enschede, The Netherlands. t.krabben@rrd.nl
authors: Thijs
authors: T
authors: Krabben
authors: Birgit I
authors: BI
authors: Molier
authors: Annemieke
authors: A
authors: Houwink
authors: Johan S
authors: JS
authors: Rietman
authors: Jaap H
authors: JH
authors: Buurke
authors: Gerdienke B
authors: GB
authors: Prange
mesh_terms: D001696:Biomechanical Phenomena; D005260:Female; D006236:Handwriting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D020127:Recovery of Function; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis