Concurrent and Predictive Validity of Arm Kinematics With and Without a Trunk Restraint During a Reaching Task in Individuals With Stroke.
OBJECTIVE
To examine the concurrent and predictive validity of measurements of kinematic variables during reaching tasks with and without a trunk constraint in individuals with stroke.


METHODS
Randomized controlled trials.


METHODS
Hospitals and a laboratory.


METHODS
Individuals with stroke (N=95) enrolled in previous and ongoing clinical trials.


METHODS
Upper limb training protocols were 90 to 120 minutes of intervention every weekday for 3 to 4 weeks.


METHODS
Functional capacity was assessed using the Action Research Arm Test and motor impairment using the Fugl-Meyer Assessment for the Upper Extremity. Movement kinematics were measured during a reaching task with and without a trunk constraint. We derived 5 endpoint control variables and 3 joint recruitment variables for estimating concurrent and predictive validity.


RESULTS
The adjusted R(2) values for the constraint tasks ranged from .24 to .38 and for the unconstraint tasks from .29 to .40. Movement time was the most prominent kinematic variable for the Fugl-Meyer Assessment for the Upper Extremity before and after the intervention (P<.05). For the Action Research Arm Test, movement time and endpoint displacement were the most significant variables before and after the intervention, respectively (P<.05).


CONCLUSIONS
Measuring kinematic performance during an unconstrained task is appropriate and possibly sufficient to represent motor impairment and functional capacity of individuals with stroke. Movement time is the dominant variable associated with motor impairment and functional capacity, and endpoint displacement is unique in reflecting functional capacity of individuals with stroke.
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
Kuan-yi
KY
Li
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Keh-chung
KC
Lin
Department of Physical Medicine and Rehabilitation, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chih-kuang
CK
Chen
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Rong-jiuan
RJ
Liing
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. Electronic address: cywu@mail.cgu.edu.tw.
Ching-yi
CY
Wu
Department of Physical Medicine and Rehabilitation, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan.
Wan-ying
WY
Chang
D001132:Arm / Q000503:physiopathology; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D015203:Reproducibility of Results; D000071939:Stroke Rehabilitation; D060726:Torso / Q000503:physiopathology*; D034941:Upper Extremity / Q000503:physiopathology*
Functional residual capacity; Kinematics; Motor; Rehabilitation; Validity