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Comprehensive neuromechanical assessment in stroke patients: Reliability and responsiveness of a protocol to measure neural and non-neural wrist properties
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نویسنده
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van der krogt h. ,klomp a. ,de groot j.h. ,de vlugt e. ,van der helm f.c.t. ,meskers c.g.m. ,arendzen j.h.
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منبع
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journal of neuroengineering and rehabilitation - 2015 - دوره : 12 - شماره : 1
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چکیده
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Background: understanding movement disorder after stroke and providing targeted treatment for post stroke patients requires valid and reliable identification of biomechanical (passive) and neural (active and reflexive) contributors. aim of this study was to assess test-retest reliability of passive,active and reflexive parameters and to determine clinical responsiveness in a cohort of stroke patients with upper extremity impairments and healthy volunteers. methods: thirty-two community-residing chronic stroke patients with an impairment of an upper limb and fourteen healthy volunteers were assessed with a comprehensive neuromechanical assessment protocol consisting of active and passive tasks and different stretch reflex-eliciting measuring velocities,using a haptic manipulator and surface electromyography of wrist flexor and extensor muscles (netherlands trial registry number ntr1424). intraclass correlation coefficients (icc) and standard error of measurement were calculated to establish relative and absolute test-retest reliability of passive,active and reflexive parameters. clinical responsiveness was tested with kruskal wallis test for differences between groups. results: icc of passive parameters were fair to excellent (0.45 to 0.91). icc of active parameters were excellent (0.88-0.99). icc of reflexive parameters were fair to good (0.50-0.74). only the reflexive loop time of the extensor muscles performed poor (icc 0.18). significant differences between chronic stroke patients and healthy volunteers were found in ten out of fourteen parameters. conclusions: passive,active and reflexive parameters can be assessed with high reliability in post-stroke patients. parameters were responsive to clinical status. the next step is longitudinal measurement of passive,active and reflexive parameters to establish their predictive value for functional outcome after stroke. © 2015 van der krogt et al.; licensee biomed central.
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کلیدواژه
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Biomechanics; Stretch reflex; Stroke; Validation studies; Wrist
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آدرس
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department of rehabilitation medicine,leiden university medical center,postzone b0-q,p.o. box 9600,leiden,2300 rc, Netherlands, department of rehabilitation medicine,leiden university medical center,postzone b0-q,p.o. box 9600,leiden,2300 rc,netherlands,laboratory for neuromuscular control,faculty of mechanical,maritime and materials engineering,delft university of technology,mekelweg 2,delft,2628 cd, Netherlands, department of rehabilitation medicine,leiden university medical center,postzone b0-q,p.o. box 9600,leiden,2300 rc, Netherlands, laboratory for neuromuscular control,faculty of mechanical,maritime and materials engineering,delft university of technology,mekelweg 2,delft,2628 cd, Netherlands, laboratory for neuromuscular control,faculty of mechanical,maritime and materials engineering,delft university of technology,mekelweg 2,delft,2628 cd, Netherlands, department of rehabilitation medicine,leiden university medical center,postzone b0-q,p.o. box 9600,leiden,2300 rc,netherlands,department of rehabilitation medicine,vu medical center,de boelelaan 1117,amsterdam,1081 hv, Netherlands, department of rehabilitation medicine,leiden university medical center,postzone b0-q,p.o. box 9600,leiden,2300 rc, Netherlands
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Authors
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