title: Kinematic measures for upper limb motor assessment during robot-mediated training in patients with severe sub-acute stroke.
abstract: OBJECTIVE
  Kinematic assessments are increasingly used as motor outcome measures during upper limb robot-assisted training, in addition to clinical scales. However, their relevance has not been evaluated much.
  
  
  METHODS
  Thirty-eight patients with severe sub-acute stroke (age 56 ± 17 [19-87] years; time since stroke, 55 ± 22 days) carried out 16 sessions (average 3/week, 35 ± 15 days) of upper limb robot-assisted training combined with standard therapy. Pre/post motor performance was evaluated using the Fugl-Meyer Assessment scale, Motor Status Scale (MSS) and kinematic measures. Motor outcomes were compared and relationships between clinical and kinematic outcomes were analyzed.
  
  
  RESULTS
  All clinical and kinematic outcomes improved after training (p <  0.01). FM score increased from 17.7 ± 10.0 to 28.6 ± 15.4. All baseline kinematic measures were strongly correlated with clinical scores. Correlations between clinical and kinematic changes were moderate (r = -0.65 for change in FM Proximal score and change in accuracy measure). However, smoothness and accuracy indicators were shown to be responsive measures.
  
  
  CONCLUSIONS
  This study demonstrated that baseline kinematic measures and their pre/post training changes were significantly correlated with clinical motor outcome measures. However, even if kinematic measures are valid for the evaluation of motor impairment we cannot propose to substitute common clinical measures of motor function which also evaluate functional abilities of the upper limb.
authors.affiliation: CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, Boissise-Le-Roi, France.|Centre Hospitalier Sud Francilien, Neurologie, Corbeil-Essonnes, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Duret
authors.affiliation: CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, Boissise-Le-Roi, France.
authors.forename: Ophélie
authors.initials: O
authors.lastname: Courtial
authors.affiliation: CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, Boissise-Le-Roi, France.
authors.forename: Anne Gaelle
authors.initials: AG
authors.lastname: Grosmaire
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena / Q000502:physiology*; D002545:Brain Ischemia / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011597:Psychomotor Performance; D020127:Recovery of Function; D012189:Retrospective Studies; D012371:Robotics; D012720:Severity of Illness Index; D013223:Statistics as Topic; D020521:Stroke / Q000209:etiology / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
keywords: Hemiparesis; kinematics; robotic therapy; sub-acute stroke; upper limb