title: The Virtual Peg Insertion Test as an assessment of upper limb coordination in ARSACS patients: a pilot study.
abstract: OBJECTIVE
  This paper introduces a novel assessment tool to provide clinicians with quantitative and more objective measures of upper limb coordination in patients suffering from Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS). The Virtual Peg Insertion Test (VPIT) involves manipulating an instrumented handle in order to move nine pegs into nine holes displayed in a virtual environment. The main outcome measures were the number of zero-crossings of the hand acceleration vector, as a measure of movement coordination and the total time required to complete the insertion of the nine pegs, as a measure of overall upper limb performance.
  
  
  RESULTS
  8\9 patients with ARSACS were able to complete five repetitions with the VPIT. Patients were found to be significantly less coordinated and slower than age-matched healthy subjects (p<0.01). Performance of ARSACS patients was positively correlated with the Nine-Hole Peg Test (r=0.85, p<0.01) and with age (r=0.93, p<0.01), indicative of the degenerative nature of the disease.
  
  
  CONCLUSIONS
  This study presents preliminary results on the use of a robotics and virtual reality assessment tool with ARSACS patients. Results highlight its potential to assess impaired coordination and monitor its progression over time.
authors.affiliation: Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Québec, Canada; Centre hospitalier affilié universitaire régional (CAUR) de Chicoutimi, Centre de santé et de services sociaux de Chicoutimi, Chicoutimi, Québec, Canada; School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada. Electronic address: cynthia.gagnon4@usherbrooke.ca.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gagnon
authors.affiliation: Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Québec, Canada; Clinique des maladies neuromusculaires, Centre de réadaptation en déficience physique Le Parcours du Centre de santé et de services sociaux de Jonquière, Québec, Canada; Centre hospitalier affilié universitaire régional (CAUR) de Chicoutimi, Centre de santé et de services sociaux de Chicoutimi, Chicoutimi, Québec, Canada; School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lavoie
authors.affiliation: Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Québec, Canada; Clinique des maladies neuromusculaires, Centre de réadaptation en déficience physique Le Parcours du Centre de santé et de services sociaux de Jonquière, Québec, Canada; Centre hospitalier affilié universitaire régional (CAUR) de Chicoutimi, Centre de santé et de services sociaux de Chicoutimi, Chicoutimi, Québec, Canada; School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lessard
authors.affiliation: Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Québec, Canada; Clinique des maladies neuromusculaires, Centre de réadaptation en déficience physique Le Parcours du Centre de santé et de services sociaux de Jonquière, Québec, Canada; Centre hospitalier affilié universitaire régional (CAUR) de Chicoutimi, Centre de santé et de services sociaux de Chicoutimi, Chicoutimi, Québec, Canada; School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Mathieu
authors.affiliation: Montreal Neurological Institute, McGill University, Québec, Canada.
authors.forename: Bernard
authors.initials: B
authors.lastname: Brais
authors.affiliation: Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bouchard
authors.affiliation: Rehabilitation Engineering Laboratory, ETH Zurich, Switzerland.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Fluet
authors.affiliation: Rehabilitation Engineering Laboratory, ETH Zurich, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Gassert
authors.affiliation: Rehabilitation Engineering Laboratory, ETH Zurich, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lambercy
mesh_terms: D000328:Adult; D001259:Ataxia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D004867:Equipment Design / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009128:Muscle Spasticity / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D012046:Rehabilitation / Q000295:instrumentation* / Q000379:methods; D020754:Spinocerebellar Ataxias / Q000150:complications / Q000151:congenital* / Q000503:physiopathology / Q000534:rehabilitation; D013647:Task Performance and Analysis; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Coordination; Instrument; Instrumented assessment tool; Outcome assessment (health care); Spastic Ataxia of Charlevoix–Saguenay type; User–computer interface