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A composite robotic-based measure of upper limb proprioception.

Jeffrey M Kenzie1, Jennifer A Semrau2, Michael D Hill3

  • 1Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada. jmkenzie@ucalgary.ca.

Journal of Neuroengineering and Rehabilitation
|November 15, 2017
PubMed
Summary

Stroke survivors often experience proprioceptive deficits. This study developed a robotic system to quantify upper limb proprioception, creating a reliable composite score for clinical trials.

Keywords:
KinesthesiaOutcome measurePosition senseProprioceptionRoboticsStrokeUpper extremity

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Biomechanics

Background:

  • Proprioception, the sense of limb position and movement, is crucial for coordinated motor control.
  • Proprioceptive impairments are prevalent after stroke, yet current clinical assessments are unreliable.
  • Novel kinematic parameters are needed to accurately quantify proprioceptive deficits.

Purpose of the Study:

  • To develop and validate kinematic parameters for quantifying upper limb proprioception in stroke survivors.
  • To compare Euclidean and Mahalanobis distances for creating a composite proprioceptive function score.
  • To establish a reliable outcome measure for use in stroke rehabilitation clinical trials.

Main Methods:

  • Utilized the KINARM robotic exoskeleton for upper limb proprioception assessment in 285 stroke subjects.
  • Employed mirror-matching tasks without vision to evaluate position sense and kinesthetic sense.
  • Calculated Euclidean and Mahalanobis distances of z-scores for 20 quantified proprioceptive parameters.

Main Results:

  • A significant majority of stroke subjects exhibited proprioceptive impairments (57% position, 65% kinesthesia, 62% overall).
  • Robotic-derived measures strongly correlated with clinical assessments of upper extremity function and independence.
  • Composite scores from Euclidean and Mahalanobis distances demonstrated high content validity (r=0.97-0.99).

Conclusions:

  • A composite measure integrating multiple proprioceptive aspects (position, direction, speed, amplitude) was developed.
  • This provides a single, continuous outcome measure for assessing proprioceptive function in clinical rehabilitation studies.
  • Mahalanobis distance is recommended over Euclidean distance for its preferred metric properties.