The feasibility of using robotic technology to quantify sensory, motor, and cognitive impairments associated with ALS

Abstract

Objective: We used the KINARM robot to quantify impairments in cognitive and upper-limb sensorimotor performance in a cohort of people with amyotrophic lateral sclerosis (ALS). We sought to study the feasibility of using this technology for ALS research, to quantify patterns of impairments in individuals living with ALS, and elucidate correlations between robotic and traditional clinical behavioral measures. Methods: Participants completed robot-based behavioral tasks testing sensorimotor, cognitive, and proprioceptive performance. Performance on robotic tasks was normalized to a large healthy control cohort (no neurological impairments), adjusted for age. Task impairment was defined as performance outside the 95% range of controls. Traditional clinical tests included: Frontal Assessment Battery (FAB), ALS Functional Rating Scale-Revised (ALSFRS-R), and Montreal Cognitive Assessment (MoCA). Results: Seventeen people with ALS were assessed. Two participants reported pain or discomfort from the robot's seat and 2 others reported discomfort from arm position during the assessment (both rectified and did not affect exam completion). Participants were able to perform the majority of the robotic tasks, although 9 participants were unable to complete 1 or more tasks. Between 20 and 69% of participants displayed sensorimotor impairments; 19 and 69% displayed cognitive task impairments; 25% displayed proprioceptive impairments. MoCA was impaired in 9/17 participants; 10/17 had impaired performance on FAB. MoCA and FAB correlated well with robot-based measures of cognition. Conclusion: Use of robotic assessment is generally feasible for people with ALS. Individuals with ALS have sensorimotor impairments as expected, and some demonstrate substantial cognitive impairments.

Assessing various sensorimotor and cognitive functions in people with epilepsy is feasible with robotics

“…The Kinarm robotic assessment system (Kinarm, Kingston, ON, Canada) is a tool that quantifies performance on a collection of behavioral tasks that test motor, cognitive, and sensory functions, referred to as Kinarm Standard Tests™ (KSTs). It has been used to characterize deficits in a variety of clinical populations such as stroke ( [14][15][16]), ALS [17], Parkinson's disease [18], TIA [19], and concussion [20]. Furthermore, previous work has highlighted the test-retest reliability of Kinarm assessment results [21].…”

The feasibility of assessing cognitive and motor function in multiple sclerosis patients using robotics

“…Two tasks (VGR and RVGR) generated three values each as these tasks were tested in the dominant (VGR-D, RVGR-D) and non-dominant (VGR-ND, RVGR-ND) arms, and the inter-limb score was calculated (VGR-IL, RVGR-IL). 14 One task (APM) generated two values representing dominant (APM-D) and non-dominant (APM-ND) arm. These operations were performed using Matlab R2018a (The Mathworks, Natick, MA).…”

“…executive functions), in people with MS and compare these measurements to standard clinical assessment tools. Kinarm has been used to assess individuals with diverse neurological conditions, including stroke, 11 – 13 amyotrophic lateral sclerosis, 14 and concussion. 15 Previous work assessing upper-limb function using robotics in people with MS has provided detailed accounts of individual kinematic parameters in some instances, 16 and purely motor skill in others.…”

New technologies and Amyotrophic Lateral Sclerosis – Which step forward rushed by the COVID-19 pandemic?

“…Simmatis et al (2019) used the KINARM robot to quantify UL sensorimotor and cognitive involvement in 17 ALS patients [82]. Cognitive involvement was correlated to the MoCA and FAB tests and sensorimotor and proprioceptive impairments were identified.…”