Clinical validation of kinematic assessments of post-stroke upper limb movements with a multi-joint arm exoskeleton

Journal of NeuroEngineering and Rehabilitation

Florian Grimm¹  Jelena Kraugmann¹  Georgios Naros¹  Alireza Gharabaghi¹ 

[1] Department of Neurosurgery and Neurotechnology, Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Otfried-Mueller-Str. 45, 72076, Tübingen, Germany;

关键词: Human–machine interface;    Exoskeleton;    Sensorimotor interaction;    Virtual reality;    Hand-arm model;    Movement analysis;    Rehabilitation robotics;    Neurorehabilitation;    Stroke;   

DOI  :  10.1186/s12984-021-00875-7

来源: Springer

【 摘 要 】

BackgroundThe clinical evaluation of the upper limb of severely impaired stroke patient is challenging. Sensor-based assessments may allow for an objective evaluation of this patient population. This study investigated the validity of a device-assisted approach in comparison to the clinical outcome that it is supposed to reflect.MethodsIn nineteen severely impaired chronic stroke patients, we applied a gravity-compensating, multi-joint arm exoskeleton (Armeo Spring) and compared this sensor-based assessment with the clinical outcome measure Upper Extremity Fugl-Meyer Assessment (UE-FMA) scale. Specifically, we assessed separately and subsequently the range of motion in joint space for four single joints (i.e., wrist, elbow and shoulder flexion/extension (FE), and shoulder internal/external rotation (IER)), and the closing and opening of the hand with a pressure sensor placed in the handle.ResultsWithin the kinematic parameters, a strong correlation was observed between wrist and elbow FE (r > 0.7, p < 0.003; Bonferroni corrected). The UE-FMA was significantly predicted by a multiple regression model (F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83). Both shoulder IER and grip pressure added significantly (p < 0.05) to the prediction with the standardized coefficients β of 0.55 and 0.38, respectively.ConclusionsBy applying an exoskeleton-based self-contained evaluation of single-joint movements, a clinically valid assessment of the upper limb range of motion in severely impaired stroke patients is feasible. Shoulder IER contributed most relevantly to the prediction of the clinical status. These findings need to be confirmed in a large, independent patient cohort.

【 授权许可】

CC BY