Design and Preliminary Evaluation of a Perturbation-based Robot-assisted Assessment of Hand Sensorimotor Impairments

Zbytniewska, Monika; Siegenthaler, Marc; Kanzler, Christoph M.; Hermsdörfer, Joachim; Gassert, Roger; Lambercy, Olivier

doi:10.1109/biorob49111.2020.9224412

Cited by 4 publications

(5 citation statements)

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“…The ETH MIKE (Motor Impairment and Kinesthetic Evaluation) 2 is a one degree of freedom end-effector robot, which can provide well-controlled stimuli to the index finger and sensitively measure subjects' kinematic and kinetic responses [41,42]. The end-effector has its center of rotation aligned with the MCP joint of the index finger.…”

Section: Robot-assisted Assessments Apparatusmentioning

confidence: 99%

“…The objective of this work was to propose and evaluate a new set of assessments of hand proprioceptive, motor and sensorimotor impairments, implemented on a single, previously described robotic platform (ETH MIKE: Motor Impairment and Kinesthetic Evaluation) [41,42]. This one degree-of-freedom end-effector device can provide well-controlled movement stimuli to the index finger metacarpophalangeal (MCP) joint and sensitively measure its kinematic and kinetic responses.…”

Section: Introductionmentioning

confidence: 99%

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Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Zbytniewska

Kanzler

Jordan

et al. 2021

J NeuroEngineering Rehabil

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Background Neurological injuries such as stroke often differentially impair hand motor and somatosensory function, as well as the interplay between the two, which leads to limitations in performing activities of daily living. However, it is challenging to identify which specific aspects of sensorimotor function are impaired based on conventional clinical assessments that are often insensitive and subjective. In this work we propose and validate a set of robot-assisted assessments aiming at disentangling hand proprioceptive from motor impairments, and capturing their interrelation (sensorimotor impairments). Methods A battery of five complementary assessment tasks was implemented on a one degree-of-freedom end-effector robotic platform acting on the index finger metacarpophalangeal joint. Specifically, proprioceptive impairments were assessed using a position matching paradigm. Fast target reaching, range of motion and maximum fingertip force tasks characterized motor function deficits. Finally, sensorimotor impairments were assessed using a dexterous trajectory following task. Clinical feasibility (duration), reliability (intra-class correlation coefficient ICC, smallest real difference SRD) and validity (Kruskal-Wallis test, Spearman correlations $$\rho$$ ρ with Fugl-Meyer Upper Limb Motor Assessment, kinesthetic Up-Down Test, Box & Block Test) of robotic tasks were evaluated with 36 sub-acute stroke subjects and 31 age-matched neurologically intact controls. Results Eighty-three percent of stroke survivors with varied impairment severity (mild to severe) could complete all robotic tasks (duration: <15 min per tested hand). Further, the study demonstrated good to excellent reliability of the robotic tasks in the stroke population (ICC>0.7, SRD<30%), as well as discriminant validity, as indicated by significant differences (p-value<0.001) between stroke and control subjects. Concurrent validity was shown through moderate to strong correlations ($$\rho$$ ρ =0.4-0.8) between robotic outcome measures and clinical scales. Finally, robotic tasks targeting different deficits (motor, sensory) were not strongly correlated with each other ($$\rho \le$$ ρ ≤ 0.32, p-value>0.1), thereby presenting complementary information about a patient’s impairment profile. Conclusions The proposed robot-assisted assessments provide a clinically feasible, reliable, and valid approach to distinctly characterize impairments in hand proprioceptive and motor function, along with the interaction between the two. This opens new avenues to help unravel the contributions of unique aspects of sensorimotor function in post-stroke recovery, as well as to contribute to future developments towards personalized, assessment-driven therapies.

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Section: Robot-assisted Assessments Apparatusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Zbytniewska

Kanzler

Jordan

et al. 2021

J NeuroEngineering Rehabil

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View full text Add to dashboard Cite

show abstract

“…The ETH MIKE is a one-degree-of-freedom end-effector device, that can be used to measure impairment of proprioception, motor and sensorimotor function in the metacarpophalangeal joint of the index finger (23,54,55). The ETH MIKE provides well-controlled stimuli to the index finger and sensitively measures the kinematic and kinetic responses, and has been shown to be safe and feasible in post-stroke individuals with mild to severe disability levels (23).…”

Section: Eth Motor Impairment and Kinesthetic Evaluation (Mike)mentioning

confidence: 99%

Upper limb sensorimotor recovery in Asian stroke survivors: a study protocol for the development and implementation of a Technology-Assisted dIgitaL biOmaRker (TAILOR) platform

Cheng,

Chin,

Kanzler

et al. 2023

Front. Neurol.

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BackgroundStroke is a leading cause of lifelong disability worldwide, partially driven by a reduced ability to use the upper limb in daily life causing increased dependence on caregivers. However, post-stroke functional impairments have only been investigated using limited clinical scores, during short-term longitudinal studies in relatively small patient cohorts. With the addition of technology-based assessments, we propose to complement clinical assessments with more sensitive and objective measures that could more holistically inform on upper limb impairment recovery after stroke, its impact on upper limb use in daily life, and on overall quality of life. This paper describes a pragmatic, longitudinal, observational study protocol aiming to gather a uniquely rich multimodal database to comprehensively describe the time course of upper limb recovery in a representative cohort of 400 Asian adults after stroke. Particularly, we will characterize the longitudinal relationship between upper limb recovery, common post-stroke impairments, functional independence and quality of life.MethodsParticipants with stroke will be tested at up to eight time points, from within a month to 3 years post-stroke, to capture the influence of transitioning from hospital to community settings. We will perform a battery of established clinical assessments to describe the factors most likely to influence upper limb recovery. Further, we will gather digital health biomarkers from robotic or wearable sensing technology-assisted assessments to sensitively characterize motor and somatosensory impairments and upper limb use in daily life. We will also use both quantitative and qualitative measures to understand health-related quality of life. Lastly, we will describe neurophysiological motor status using transcranial magnetic stimulation.StatisticsDescriptive analyses will be first performed to understand post-stroke upper limb impairments and recovery at various time points. The relationships between digital biomarkers and various domains will be explored to inform key aspects of upper limb recovery and its dynamics using correlation matrices. Multiple statistical models will be constructed to characterize the time course of upper limb recovery post-stroke. Subgroups of stroke survivors exhibiting distinct recovery profiles will be identified.ConclusionThis is the first study complementing clinical assessments with technology-assisted digital biomarkers to investigate upper limb sensorimotor recovery in Asian stroke survivors. Overall, this study will yield a multimodal data set that longitudinally characterizes post-stroke upper limb recovery in functional impairments, daily-life upper limb use, and health-related quality of life in a large cohort of Asian stroke survivors. This data set generates valuable information on post-stroke upper limb recovery and potentially allows researchers to identify different recovery profiles of subgroups of Asian stroke survivors. This enables the comparisons between the characteristics and recovery profiles of stroke survivors in different regions. Thus, this study lays out the basis to identify early predictors for upper limb recovery, inform clinical decision-making in Asian stroke survivors and establish tailored therapy programs.Clinical trial registrationClinicalTrials.gov, identifier: NCT05322837.

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“…The ETH MIKE (Motor Impairment and Kinesthetic Evaluation) is a one degree of freedom end-effector robot, which can provide well-controlled stimuli to the index finger and sensitively measure subjects' kinematic and kinetic responses [40,41].…”

Section: Apparatusmentioning

confidence: 99%

“…Motor Impairment and Kinesthetic Evaluation) [40,41]. This one degree-of-freedom end-effector device can provide well-controlled movement stimuli to the index finger metacarpophalangeal (MCP) joint and sensitively measure kinematic and kinetic responses.…”

Section: Introductionmentioning

confidence: 99%

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Zbytniewska

Kanzler

Jordan

et al. 2020

Preprint

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View full text Add to dashboard Cite

Background: Neurological injuries such as stroke often differentially impair hand motor and somatosensory function, as well as the interplay between the two, which leads to limitations in performing activities of daily living. However, it is challenging to identify which specific aspects of sensorimotor function are impaired based on conventional clinical assessments that are often insensitive and subjective. In this work we propose and validate a set of robot-assisted assessments aiming at disentangling hand proprioceptive from motor impairments, and capturing their interrelation (sensorimotor impairments). Methods: For this purpose, a battery of five complementary assessment tasks was implemented on a one degree-of-freedom end-effector robotic platform acting on the index finger metacarpophalangeal joint. Specifically, proprioceptive impairments were assessed using a position matching paradigm. Fast target reaching, range of motion and maximum fingertip force tasks characterized motor function deficits. Finally, sensorimotor impairments were assessed using a dexterous trajectory following task. Clinical feasibility (duration), reliability (intra-class correlation coefficient ICC, smallest real difference SRD) and validity (Kruskal-Wallis test, Spearman correlations rho) of these tasks were evaluated with 36 sub-acute stroke subjects and 31 age-matched neurologically intact controls. Results: Eighty-three percent of stroke survivors with varied impairment severity (mild to severe) could complete all robotic tasks (duration: <15 min per tested hand). Further, the study demonstrated good to excellent reliability of the robotic tasks in the stroke population (ICC>0.7, SRD<30%), as well as discriminant validity, as indicated by significant differences (p-value<0.001) between stroke and control subjects on all metrics extracted from the robotic tasks. Concurrent validity was shown through moderate to strong correlations (rho=0.4-0.8) between the robotic outcome measures and clinical scales. Finally, robotic tasks targeting different deficits were not strongly correlated, thereby presenting complementary information about a patient’s impairment profile. Conclusions: The proposed robot-assisted assessments provide a clinically feasible, reliable, and valid approach to distinctly characterize impairments in hand proprioceptive and motor function, along with the interaction between the two. This opens new avenues to help unravel the contributions of unique aspects of sensorimotor function in post-stroke recovery, as well as to contribute to future developments towards personalized, assessment-driven therapies.

show abstract

Design and Preliminary Evaluation of a Perturbation-based Robot-assisted Assessment of Hand Sensorimotor Impairments

Cited by 4 publications

References 35 publications

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Upper limb sensorimotor recovery in Asian stroke survivors: a study protocol for the development and implementation of a Technology-Assisted dIgitaL biOmaRker (TAILOR) platform

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

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