Testing a motor performance series and a kinematic motion analysis as measures of performance in high-functioning stroke patients: Reliability, validity, and responsiveness to therapeutic intervention

Platz, Thomas; Prass, Konstantin; Denzler, Petra; Bock, S; Mauritz, Karl-Heinz

doi:10.1016/s0003-9993(99)90137-5

Cited by 45 publications

(33 citation statements)

References 14 publications

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“…Deficits may only be apparent with more sensitive kinematic testing [35]. These patients, however, are the most likely to return to work after their stroke and so their deficits, albeit mild, can be devastating, for example, for electricians, hairdressers, or musicians.…”

Section: Rehabilitation Methods Based On Motor Learningmentioning

confidence: 99%

Motor learning: its relevance to stroke recovery and neurorehabilitation

Krakauer

2006

Current Opinion in Neurology

1,054

753

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Motor learning mechanisms are operative during spontaneous stroke recovery and interact with rehabilitative training. For optimal results, rehabilitation techniques should be geared towards patients' specific motor deficits and possibly combined, for example, CIMT with VR. Two critical questions that should always be asked of a rehabilitation technique are whether gains persist for a significant period after training and whether they generalize to untrained tasks.

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Section: Rehabilitation Methods Based On Motor Learningmentioning

confidence: 99%

Motor learning: its relevance to stroke recovery and neurorehabilitation

Krakauer

2006

Current Opinion in Neurology

1,054

753

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“…Accordingly, two specific training techniques have been developed: the Arm BASIS training for patients with severe paresis and the Arm Ability training for patients with mild arm paresis [30][31][32][33][34].…”

Section: Introductionmentioning

confidence: 99%

Impairment–oriented training and adaptive motor cortex reorganisation after stroke: a fTMS study

et al. 2005

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In a sample of 28 subacute anterior circulation ischemic stroke patients with severe arm paresis, reduced motor cortex excitability (increased motor thresholds, reduced MEP amplitudes, reduced number of active points) and a reduced conduction velocity in the corticospinal system were found in the affected hemisphere. At the same time motor cortex topology for the abductor pollicis brevis (APB) representation was comparable for the affected and non-affected hemisphere. Considerable arm motor recovery (Fugl-Meyer test) was observed when assessed four weeks later after a period of rehabilitation intervention. Motor cortex excitability and conduction velocity in the corticospinal system improved in the affected hemisphere. In addition, APB representation showed a medial shift in patients with such a representation at pre test (n=14). Multiple stepwise regression indicated that of all transcranial magnetic stimulation (TMS) parameters only the medial shift of the motor cortex map predicted motor recovery. Assessing the effect of training time (non-intensified vs. intensified therapy) and type of arm training (Bobath approach vs. Arm BASIS training) with a randomised controlled design revealed that the impairment-oriented Arm BASIS training improved motor control more than the control conditions. In addition, patients of the group receiving the Arm BASIS training with an APB representation at pre test showed a medial shift of the motor cortex map and improved conduction times. In conclusion, changes in motor cortex topology were likely to be relevant for motor recovery and might have been induced by the impairment-oriented training.

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“…1,2 Kinematic measurement has revealed differences in arm movement patterns during reaching tasks between (1) healthy control subjects (dominant arm) and individuals with stroke (more-affected arm) 3 ; and (2) individuals with stroke (more-affected versus less-affected arms). 4 For example, motor performance measures revealed that tapping with a stylus, requiring wrist flexion/extension, and 3-dimensional pointing movements were less precise and slower in the hemiparetic arm compared with healthy control subjects despite clinically assessed mild levels of arm motor impairment (strength Ն4/5 on the Medical Research Council Scale 5 or Ն50/66 on UL FuglMeyer Assessment (FMA). 6 This suggests that motor performance variables may better identify motor control deficits than clinical outcome measures.…”

mentioning

confidence: 99%

Validity of Movement Pattern Kinematics as Measures of Arm Motor Impairment Poststroke

Subramanian

Yamanaka

Chilingaryan

et al. 2010

Stroke

144

167

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Background and Purpose-Upper limb motor impairment poststroke is commonly evaluated using clinical outcome measures such as the Fugl-Meyer Assessment. However, most clinical measures provide little information about motor patterns and compensations (eg, trunk displacement) used for task performance. Such information is obtained using movement quality kinematic variables (joint ranges, trunk displacement). Evaluation of movement quality may also help distinguish between levels of motor impairment severity in individuals poststroke. Our objective was to estimate concurrent and discriminant validity of movement quality kinematic variables for pointing and reach-to-grasp tasks. Methods-A retrospective study of kinematic data (sagittal trunk displacement, shoulder flexion, shoulder horizontal adduction, elbow extension) and Fugl-Meyer Assessment scores from 86 subjects (subacute to chronic stroke) performing pointing and reaching tasks was done. Multiple and logistic regression analyses were used to estimate concurrent and discriminant validity respectively. Cutoff points for distinguishing between levels of upper limb motor impairment severity (mild, moderate to severe) were estimated using sensitivity/specificity decision plots. The criterion measure used was the Fugl-Meyer Assessment (upper limb section). Results-The majority of variance in Fugl-Meyer Assessment scores was explained by a combination of trunk displacement and shoulder flexion (51%) for the pointing task and by trunk displacement alone (52%) for the reach-to-grasp task. Trunk displacement was the only variable that distinguished between levels of motor impairment severity. Cutoff points were 4.8 cm for pointing and 10.2 cm for reach-to-grasp movements. Conclusion-Movement

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Testing a motor performance series and a kinematic motion analysis as measures of performance in high-functioning stroke patients: Reliability, validity, and responsiveness to therapeutic intervention

Cited by 45 publications

References 14 publications

Motor learning: its relevance to stroke recovery and neurorehabilitation

Motor learning: its relevance to stroke recovery and neurorehabilitation

Impairment–oriented training and adaptive motor cortex reorganisation after stroke: a fTMS study

Validity of Movement Pattern Kinematics as Measures of Arm Motor Impairment Poststroke

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