title: Validation of a Quantitative Single-Subject Based Evaluation for Rehabilitation-Induced Improvement Assessment.
abstract: The foreseen outcome of a rehabilitation treatment is a stable improvement on the functional outcomes, which can be longitudinally assessed through multiple measures to help clinicians in functional evaluation. In this study, we propose an automatic comprehensive method of combining multiple measures in order to assess a functional improvement. As test-bed, a functional electrical stimulation based treatment for foot drop correction performed with chronic post-stroke participants is presented. Patients were assessed on five relevant outcome measures before, after intervention, and at a follow-up time-point. A novel algorithm based on variables minimum detectable change is proposed and implemented in a custom-made software, combining the outcome measures to obtain a unique parameter: capacity score. The difference between capacity scores at different timing is three holded to obtain improvement evaluation. Ten clinicians evaluated patients on the Improvement Clinical Global Impression scale. Eleven patients underwent the treatment, and five resulted to achieve a stable functional improvement, as assessed by the proposed algorithm. A statistically significant agreement between intra-clinicians and algorithm-clinicians evaluations was demonstrated. The proposed method evaluates functional improvement on a single-subject yes/no base by merging different measures (e.g., kinematic, muscular) and it is validated against clinical evaluation.
authors.affiliation: NearLab - Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via G. Colombo 40, 20133, Milan, Italy. marta.gandolla@polimi.it.
authors.forename: Marta
authors.initials: M
authors.lastname: Gandolla
authors.affiliation: Villa Beretta Rehabilitation Center, Valduce Hospital, Via N. Sauro 17, 23845, Costa Masnaga, LC, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Molteni
authors.affiliation: Sobell Department of Movement Neuroscience, UCL Institute of Neurology, 33 Queen Square, London, UK.
authors.forename: Nick S
authors.initials: NS
authors.lastname: Ward
authors.affiliation: Villa Beretta Rehabilitation Center, Valduce Hospital, Via N. Sauro 17, 23845, Costa Masnaga, LC, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Guanziroli
authors.affiliation: NearLab - Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via G. Colombo 40, 20133, Milan, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ferrigno
authors.affiliation: NearLab - Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via G. Colombo 40, 20133, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pedrocchi
mesh_terms: D000328:Adult; D000465:Algorithms; D004599:Electric Stimulation Therapy; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000534:rehabilitation*; D018482:Muscle, Skeletal / Q000473:pathology; D063868:Patient Outcome Assessment; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013977:Tibia; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology; D055815:Young Adult
keywords: Algorithm for Clinical Global Impression scale for Improvement; Capacity score; Functional electrical stimulation (FES); Functional improvement; Therapeutic effect