Comprehensive neuromechanical assessment in stroke patients: reliability and responsiveness of a protocol to measure neural and non-neural wrist properties
Identifieur interne : 000A36 ( Main/Merge ); précédent : 000A35; suivant : 000A37Comprehensive neuromechanical assessment in stroke patients: reliability and responsiveness of a protocol to measure neural and non-neural wrist properties
Auteurs : Hanneke Van Der Krogt [Pays-Bas] ; Asbj Rn Klomp [Pays-Bas] ; Jurriaan H. De Groot [Pays-Bas] ; Erwin De Vlugt [Pays-Bas] ; Frans Ct Van Der Helm [Pays-Bas] ; Carel Gm Meskers [Pays-Bas] ; J Hans Arendzen [Pays-Bas]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2015.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Biomechanical Phenomena, Brain Ischemia (complications), Brain Ischemia (physiopathology), Cohort Studies, Electromyography, Female, Functional Laterality, Humans, Male, Middle Aged, Muscle Contraction, Muscle, Skeletal (physiopathology), Range of Motion, Articular, Reflex, Stretch, Reproducibility of Results, Stroke (diagnosis), Stroke (physiopathology), Wrist (innervation), Wrist (physiopathology), Wrist Joint (physiopathology), Young Adult.
- MESH :
- complications : Brain Ischemia.
- diagnosis : Stroke.
- innervation : Wrist.
- physiopathology : Brain Ischemia, Muscle, Skeletal, Stroke, Wrist, Wrist Joint.
- Adolescent, Adult, Aged, Aged, 80 and over, Biomechanical Phenomena, Cohort Studies, Electromyography, Female, Functional Laterality, Humans, Male, Middle Aged, Muscle Contraction, Range of Motion, Articular, Reflex, Stretch, Reproducibility of Results, Young Adult.
Abstract
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.
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.
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.
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.
The online version of this article (doi:10.1186/s12984-015-0021-9) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12984-015-0021-9
PubMed: 25889671
PubMed Central: 4436851
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Gm" last="Meskers">Carel Gm Meskers</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Current address: Department of Rehabilitation Medicine, VU Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Current address: Department of Rehabilitation Medicine, VU Medical Center, De Boelelaan 1117, 1081 HV Amsterdam</wicri:regionArea><wicri:noRegion>1081 HV Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Arendzen, J Hans" sort="Arendzen, J Hans" uniqKey="Arendzen J" first="J Hans" last="Arendzen">J Hans Arendzen</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25889671</idno><idno type="pmc">4436851</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436851</idno><idno type="RBID">PMC:4436851</idno><idno type="doi">10.1186/s12984-015-0021-9</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000839</idno><idno 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Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author><author><name sortKey="Klomp, Asbj Rn" sort="Klomp, Asbj Rn" uniqKey="Klomp A" first="Asbj Rn" last="Klomp">Asbj Rn Klomp</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Laboratory for Neuromuscular Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Laboratory for Neuromuscular Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="De Groot, Jurriaan H" sort="De Groot, Jurriaan H" uniqKey="De Groot J" first="Jurriaan H" last="De Groot">Jurriaan H. De Groot</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author><author><name sortKey="De Vlugt, Erwin" sort="De Vlugt, Erwin" uniqKey="De Vlugt E" first="Erwin" last="De Vlugt">Erwin De Vlugt</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Laboratory for Neuromuscular Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Laboratory for Neuromuscular Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Helm, Frans Ct" sort="Van Der Helm, Frans Ct" uniqKey="Van Der Helm F" first="Frans Ct" last="Van Der Helm">Frans Ct Van Der Helm</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Laboratory for Neuromuscular Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Laboratory for Neuromuscular Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="Meskers, Carel Gm" sort="Meskers, Carel Gm" uniqKey="Meskers C" first="Carel Gm" last="Meskers">Carel Gm Meskers</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Current address: Department of Rehabilitation Medicine, VU Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Current address: Department of Rehabilitation Medicine, VU Medical Center, De Boelelaan 1117, 1081 HV Amsterdam</wicri:regionArea><wicri:noRegion>1081 HV Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Arendzen, J Hans" sort="Arendzen, J Hans" uniqKey="Arendzen J" first="J Hans" last="Arendzen">J Hans Arendzen</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Leiden University Medical Center, Postzone B0-Q, P.O. box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Biomechanical Phenomena</term><term>Brain Ischemia (complications)</term><term>Brain Ischemia (physiopathology)</term><term>Cohort Studies</term><term>Electromyography</term><term>Female</term><term>Functional Laterality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Muscle Contraction</term><term>Muscle, Skeletal (physiopathology)</term><term>Range of Motion, Articular</term><term>Reflex, Stretch</term><term>Reproducibility of Results</term><term>Stroke (diagnosis)</term><term>Stroke (physiopathology)</term><term>Wrist (innervation)</term><term>Wrist (physiopathology)</term><term>Wrist Joint (physiopathology)</term><term>Young Adult</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Brain Ischemia</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Wrist</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Brain Ischemia</term><term>Muscle, Skeletal</term><term>Stroke</term><term>Wrist</term><term>Wrist Joint</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Biomechanical Phenomena</term><term>Cohort Studies</term><term>Electromyography</term><term>Female</term><term>Functional Laterality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Muscle Contraction</term><term>Range of Motion, Articular</term><term>Reflex, Stretch</term><term>Reproducibility of Results</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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).</p><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12984-015-0021-9) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Dobkin, Bh" uniqKey="Dobkin B">BH Dobkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kwakkel, G" uniqKey="Kwakkel G">G Kwakkel</name></author><author><name sortKey="Kollen, Bj" uniqKey="Kollen B">BJ Kollen</name></author><author><name sortKey="Van Der Grond, J" uniqKey="Van Der Grond J">J van der Grond</name></author><author><name sortKey="Prevo, Aj" uniqKey="Prevo A">AJ Prevo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gracies, Jm" 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Turk</name></author><author><name sortKey="Notley, Sv" uniqKey="Notley S">SV Notley</name></author><author><name sortKey="Pickering, Rm" uniqKey="Pickering R">RM Pickering</name></author><author><name sortKey="Simpson, Dm" uniqKey="Simpson D">DM Simpson</name></author><author><name sortKey="Wright, Pa" uniqKey="Wright P">PA Wright</name></author><author><name sortKey="Burridge, Jh" uniqKey="Burridge J">JH Burridge</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wolf, Sl" uniqKey="Wolf S">SL Wolf</name></author><author><name sortKey="Segal, Rl" uniqKey="Segal R">RL Segal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kwakkel, G" uniqKey="Kwakkel G">G Kwakkel</name></author><author><name sortKey="Meskers, Cg" uniqKey="Meskers C">CG Meskers</name></author><author><name sortKey="Van Wegen, Ee" uniqKey="Van Wegen E">EE Van Wegen</name></author><author><name sortKey="Lankhorst, Gj" uniqKey="Lankhorst G">GJ Lankhorst</name></author><author><name sortKey="Geurts, Ac" uniqKey="Geurts A">AC Geurts</name></author><author><name sortKey="Van Kuijk, Aa" uniqKey="Van Kuijk A">AA Van Kuijk</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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