Measurement properties of movement smoothness metrics for upper limb reaching movements in people with moderate to severe subacute stroke.

Autor: Cornec G; Department of Physical and Rehabilitation Medicine, CHU Brest, Brest, F-29200, France. gwenael.cornec@chu-brest.fr.; UMR 1101 LaTIM, Univ Brest, INSERM, Brest, F-29200, France. gwenael.cornec@chu-brest.fr., Lempereur M; Department of Physical and Rehabilitation Medicine, CHU Brest, Brest, F-29200, France.; UMR 1101 LaTIM, Univ Brest, INSERM, Brest, F-29200, France., Mensah-Gourmel J; Department of Physical and Rehabilitation Medicine, CHU Brest, Brest, F-29200, France.; UMR 1101 LaTIM, Univ Brest, INSERM, Brest, F-29200, France.; Pediatric Physical and Rehabilitation Medicine Department, Fondation Ildys, Rue Alain Colas, Brest, F-29200, France., Robertson J; Physical Medicine and Rehabilitation Department, AP-HP, Raymond Poincaré Hospital, Université Paris-Saclay, Team INSERM 1179, UFR de Santé Simone Veil, Versailles Saint-Quentin university, Garches, France., Miramand L; UMR 1101 LaTIM, Univ Brest, INSERM, Brest, F-29200, France.; Pediatric Physical and Rehabilitation Medicine Department, Fondation Ildys, Rue Alain Colas, Brest, F-29200, France., Medee B; Department of Physical and Rehabilitation Medicine, CHU Brest, Brest, F-29200, France., Bellaiche S; Department of Neurological Physical Medicine and Rehabilitation, Henry-Gabrielle hospital, Hospices Civils de Lyon, Saint-Genis-Laval, France., Gross R; Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, Nantes, F-44000, France., Gracies JM; Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, F-94010, France.; Laboratoire Analyse et Restauration du Mouvement, UR 7377 BIOTN, Université Paris Est Créteil (UPEC), Créteil, France., Remy-Neris O; Department of Physical and Rehabilitation Medicine, CHU Brest, Brest, F-29200, France.; UMR 1101 LaTIM, Univ Brest, INSERM, Brest, F-29200, France., Bayle N; Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, F-94010, France.; Laboratoire Analyse et Restauration du Mouvement, UR 7377 BIOTN, Université Paris Est Créteil (UPEC), Créteil, France.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2024 May 29; Vol. 21 (1), pp. 90. Date of Electronic Publication: 2024 May 29.
DOI: 10.1186/s12984-024-01382-1
Abstrakt: Background: Movement smoothness is a potential kinematic biomarker of upper extremity (UE) movement quality and recovery after stroke; however, the measurement properties of available smoothness metrics have been poorly assessed in this group. We aimed to measure the reliability, responsiveness and construct validity of several smoothness metrics.
Methods: This ancillary study of the REM-AVC trial included 31 participants with hemiparesis in the subacute phase of stroke (median time since stroke: 38 days). Assessments performed at inclusion (Day 0, D0) and at the end of a rehabilitation program (Day 30, D30) included the UE Fugl Meyer Assessment (UE-FMA), the Action Research Arm Test (ARAT), and 3D motion analysis of the UE during three reach-to-point movements at a self-selected speed to a target located in front at shoulder height and at 90% of arm length. Four smoothness metrics were computed: a frequency domain smoothness metric, spectral arc length metric (SPARC); and three temporal domain smoothness metrics (TDSM): log dimensionless jerk (LDLJ); number of submovements (nSUB); and normalized average rectified jerk (NARJ).
Results: At D30, large clinical and kinematic improvements were observed. Only SPARC and LDLJ had an excellent reliability (intra-class correlation > 0.9) and a low measurement error (coefficient of variation < 10%). SPARC was responsive to changes in movement straightness (r Spearman =0.64) and to a lesser extent to changes in movement duration (r Spearman =0.51) while TDSM were very responsive to changes in movement duration (r Spearman >0.8) and not to changes in movement straightness (non-significant correlations). Most construct validity hypotheses tested were verified except for TDSM with low correlations with clinical metrics at D0 (r Spearman <0.5), ensuing low predictive validity with clinical metrics at D30 (non-significant correlations).
Conclusions: Responsiveness and construct validity of TDSM were hindered by movement duration and/or noise-sensitivity. Based on the present results and concordant literature, we recommend using SPARC rather than TDSM in reaching movements of uncontrolled duration in individuals with spastic paresis after stroke.
Trial Registration: NCT01383512, https://clinicaltrials.gov/ , June 27, 2011.
(© 2024. The Author(s).)
Databáze: MEDLINE
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