Measures of Interjoint Coordination Post-stroke Across Different Upper Limb Movement Tasks

Area of Science:

• Biomedical Engineering
• Neurorehabilitation
• Movement Science

Background:

• Stroke often causes upper limb impairments, affecting interjoint coordination and hindering motor recovery.
• Clinical scales like the Fugl-Meyer Motor Assessment of the Upper Extremity (FMMA-UE) complement kinematic measurements for assessing movement pathologies.
• Understanding factors influencing spatiotemporal parameters is crucial for effective rehabilitation.

Purpose of the Study:

• To investigate the impact of task, tested arm, hand dominance, upper limb function, and age on kinematic parameters of the elbow, shoulder, and trunk in stroke survivors.
• To examine the construct validity of kinematic metrics by correlating them with each other and with the FMMA-UE.
• To provide objective, quantitative data to enhance the assessment of upper limb motor function after stroke.

Main Methods:

• A cross-sectional observational study involving 26 chronic stroke patients with mild to moderate upper limb motor impairment.
• Kinematic data collected using a wearable sensor suit during four functional upper limb movements.
• Analysis included joint ranges, trunk displacement, shoulder-elbow coordination metrics (correlation coefficient, median slope, curve efficiency), and correlation with FMMA-UE.

Main Results:

• Movement task and tested arm significantly affected all kinematic parameters (p < 0.05).
• Hand dominance influenced shoulder flexion/extension and curve efficiency.
• Kinematic metrics, particularly curve efficiency (r = 0.75) and shoulder flexion/extension (r = 0.68), showed strong correlations with the FMMA-UE.

Conclusions:

• Task-specific kinematic parameters are significantly influenced by the movement performed in stroke survivors.
• Kinematic analysis offers valuable, objective insights into upper limb function post-stroke, complementing traditional clinical assessments.
• Assessing diverse, real-world functional movements is essential for comprehensive motor function evaluation in stroke rehabilitation.