Robotic Measurement of Arm Movements After Stroke Establishes Biomarkers of Motor Recovery
Open accessAbstract
Background and Purpose—: Because robotic devices record the kinematics and kinetics of human movements with high resolution, we hypothesized that robotic measures collected longitudinally in patients after stroke would bear a significant relationship to standard clinical outcome measures and, therefore, might provide superior biomarkers. Methods—: In patients with moderate-to-severe acute ischemic stroke, we used clinical scales and robotic devices to measure arm movement 7, 14, 21, 30, and 90 days after the event at 2 clinical sites. The robots are interactive devices that measure speed, position, and force so that calculated kinematic and kinetic parameters could be compared with clinical assessments. Results—: Among 208 patients, robotic measures predicted well the clinical measures (cross-validated R 2 of modified Rankin scale=0.60; National Institutes of Health Stroke Scale=0.63; Fugl-Meyer=0.73; Motor Power=0.75). When suitably scaled and combined by an artificial neural network, the robotic measures demonstrated greater sensitivity in measuring the recovery of patients from day 7 to day 90 (increased standardized effect=1.47). Conclusions—: These results demonstrate that robotic measures of motor performance will more than adequately capture outcome, and the altered effect size will reduce the required sample size. Reducing sample size will likely improve study efficiency.
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- Authors
- Krebs, H. I., Krams, M., Agrafiotis, D. K., DiBernardo, A., Chavez, J. C., Littman, G. S., Yang, E., Byttebier, G., Dipietro, L., Rykman, A., McArthur, K., Hajjar, K., Lees, K. R., & Volpe, B. T.
- Affiliations
- Biogen (United States) (US)
- ORCID
- Venue
- Stroke
- Published
- 2014-01
- Volume
- 45
- Issue
- 1
- Pages
- 200-204
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC4689592
- OpenAlex
- W1973918589
- Cited by
- 154
- References
- 39
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 8 · 2023: 5 · 2022: 11 · 2021: 20 · 2020: 13 · 2019: 12 · 2018: 20 · 2017: 13 · 2016: 17 · 2015: 15 · 2014: 6
- FWCI
- 13.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD069776)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Keywords
- motor recovery, robotic measurement, biomarkers, arm movement, kinematics, kinetics, ischemic stroke, modified Rankin Scale, Fugl-Meyer Assessment, NIHSS, motor power, sample size reduction, artificial neural networks
- MeSH terms
- Stroke Rehabilitation, Aged, Arm, Biomechanical Phenomena, Data Interpretation, Statistical, Ethnicity, Female, Humans, Functional Laterality, Male, Models, Anatomic, Movement, Predictive Value of Tests, Robotics, Reproducibility of Results, Biomarkers, Nonlinear Dynamics, Recovery of Function, Stroke, Endpoint Determination
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