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Reliability and sensitivity of a wrist rig to measure motor control and spasticity in post-stroke hemiplegia

Reliability and sensitivity of a wrist rig to measure motor control and spasticity in post-stroke hemiplegia
Reliability and sensitivity of a wrist rig to measure motor control and spasticity in post-stroke hemiplegia
Background. Objective assessment of impairments after stroke is vital for evidence-based therapy and progress monitoring.

Objective. This study determines the utility of outcome measures obtained from an instrumented wrist rig for future rehabilitation trials. The tests undertaken were evaluated in terms of sensitivity to detect differences between normal and impaired participants, test-retest repeatability (repeatability coefficient and intraclass correlation coefficient [ICC]), and interrater agreement (Bland and Altman limits of agreement).

Methods . Twelve participants with chronic poststroke hemiparesis (mean 5.6 years); and 12 unimpaired volunteers performed a series of tasks in the rig. The hemiparetic arm (impaired group) and dominant arm (unimpaired group) were tested in 3 sessions on the same day by 2 assessors. Signals were analyzed to derive a tracking index (motor control), stretch index (spasticity), flexor modulation index (FMI) (muscle activation), force angle index (FAI) (stiffness), range of movement, and isometric force.

Results and Conclusions. The means of all tests differed between impaired and unimpaired participants except for range of movement into flexion, the FAI, and the FMI. Repeatability coefficients for each test are presented as benchmark values for use in future trials in which the wrist rig tests may be used to detect change. Test-retest reliability was excellent in the impaired group (ICC = 0.88-0.98) and poor to excellent in the unimpaired group (ICC = 0.06-0.89). The Bland-Altman ranges showed no bias between assessors, and that the interassessor variability was similar to that between repeats by the same assessor for most tests.
hemiparesis, motor control, spasticity, measurement, wrist
1545-9683
684-696
Turk, Ruth
9bb21965-6f9f-4c9c-8505-94df8e168f52
Notley, Scott V.
458553fe-2c63-4844-8df1-3538c4b79cda
Pickering, Ruth M.
4a828314-7ddf-4f96-abed-3407017d4c90
Simpson, David M.
53674880-f381-4cc9-8505-6a97eeac3c2a
Wright, Philip A.
0484359d-e38d-45f8-8bfd-07ed2c599100
Burridge, Jane H.
0110e9ea-0884-4982-a003-cb6307f38f64
Turk, Ruth
9bb21965-6f9f-4c9c-8505-94df8e168f52
Notley, Scott V.
458553fe-2c63-4844-8df1-3538c4b79cda
Pickering, Ruth M.
4a828314-7ddf-4f96-abed-3407017d4c90
Simpson, David M.
53674880-f381-4cc9-8505-6a97eeac3c2a
Wright, Philip A.
0484359d-e38d-45f8-8bfd-07ed2c599100
Burridge, Jane H.
0110e9ea-0884-4982-a003-cb6307f38f64

Turk, Ruth, Notley, Scott V., Pickering, Ruth M., Simpson, David M., Wright, Philip A. and Burridge, Jane H. (2008) Reliability and sensitivity of a wrist rig to measure motor control and spasticity in post-stroke hemiplegia. Neurorehabilitation and Neural Repair, 22 (6), 684-696. (doi:10.1177/1545968308315599).

Record type: Article

Abstract

Background. Objective assessment of impairments after stroke is vital for evidence-based therapy and progress monitoring.

Objective. This study determines the utility of outcome measures obtained from an instrumented wrist rig for future rehabilitation trials. The tests undertaken were evaluated in terms of sensitivity to detect differences between normal and impaired participants, test-retest repeatability (repeatability coefficient and intraclass correlation coefficient [ICC]), and interrater agreement (Bland and Altman limits of agreement).

Methods . Twelve participants with chronic poststroke hemiparesis (mean 5.6 years); and 12 unimpaired volunteers performed a series of tasks in the rig. The hemiparetic arm (impaired group) and dominant arm (unimpaired group) were tested in 3 sessions on the same day by 2 assessors. Signals were analyzed to derive a tracking index (motor control), stretch index (spasticity), flexor modulation index (FMI) (muscle activation), force angle index (FAI) (stiffness), range of movement, and isometric force.

Results and Conclusions. The means of all tests differed between impaired and unimpaired participants except for range of movement into flexion, the FAI, and the FMI. Repeatability coefficients for each test are presented as benchmark values for use in future trials in which the wrist rig tests may be used to detect change. Test-retest reliability was excellent in the impaired group (ICC = 0.88-0.98) and poor to excellent in the unimpaired group (ICC = 0.06-0.89). The Bland-Altman ranges showed no bias between assessors, and that the interassessor variability was similar to that between repeats by the same assessor for most tests.

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More information

Published date: November 2008
Keywords: hemiparesis, motor control, spasticity, measurement, wrist

Identifiers

Local EPrints ID: 65348
URI: http://eprints.soton.ac.uk/id/eprint/65348
ISSN: 1545-9683
PURE UUID: b8063287-be01-4b5f-ae7d-1881fefe7338
ORCID for Ruth Turk: ORCID iD orcid.org/0000-0001-6332-5353
ORCID for David M. Simpson: ORCID iD orcid.org/0000-0001-9072-5088
ORCID for Jane H. Burridge: ORCID iD orcid.org/0000-0003-3497-6725

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Date deposited: 13 Feb 2009
Last modified: 16 Mar 2024 03:38

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Contributors

Author: Ruth Turk ORCID iD
Author: Scott V. Notley
Author: Philip A. Wright

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