Guidance-based quantification of arm impairment following brain injury: a pilot study.

This paper reports the design and preliminary testing of a device for evaluating arm impairment after brain injury. The assisted rehabilitation and measurement (ARM) Guide is capable of mechanically guiding reaching and retrieval movements across the workspace and of measuring constraint forces and range of motion during guidance. We tested the device on four hemiplegic brain-injured individuals and four unimpaired control subjects. During guided movement, the brain-injured subjects generated distinct spatial patterns of constraint force with their impaired arms that were consistent with the standard flexion and extension "synergies" described in the clinical literature. In addition, the impaired arms exhibited well-defined workspace deficits as measured by the ARM Guide. These results suggest that constraint force and range of motion measurements during mechanically guided movement may prove useful for precise monitoring of arm impairment and of the effects of treatment techniques targeted at abnormal synergies and workspace deficits.

[1]  T. Twitchell.  The restoration of motor function following hemiplegia in man. , 1951, Brain : a journal of neurology.

[2]  E A Bullock,et al.  Post-stroke rehabilitation. , 1975, Royal Society of Health journal.

[3]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[4]  G. Müller,et al.  [Movement therapy in hemiplegia]. , 1977, Beitrage zur Orthopadie und Traumatologie.

[5]  P A Wolf,et al.  Epidemiologic profile of long-term stroke disability: the Framingham study. , 1979, Archives of physical medicine and rehabilitation.

[6]  S. O'Sullivan,et al.  Physical Rehabilitation: Assessment and Treatment , 1980 .

[7]  C. K. Yuen,et al.  Digital Filters , 1979, IEEE Transactions on Systems, Man, and Cybernetics.

[8]  Richard W. Bohannon.  Simple clinical measures. , 1987, Physical therapy.

[9]  D. Bourbonnais,et al.  Weakness in patients with hemiparesis. , 1989, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[10]  W. Rymer,et al.  Spastic hypertonia: mechanisms and measurement. , 1989, Archives of physical medicine and rehabilitation.

[11]  Patricia McKenney Moulton.  A Motor Relearning Programme for Stroke (2nd ed.) , 1989 .

[12]  Richard W. Bohannon.  Is the measurement of muscle strength appropriate in patients with brain lesions? A special communication. , 1989, Physical therapy.

[13]  Incoordination in patients with hemiparesis. , 1992, Canadian journal of public health = Revue canadienne de sante publique.

[14]  S. C. Gandevia,et al.  Strength Changes in Hemiparesis: Measurements and Mechanisms , 1993 .

[15]  David Burke,et al.  Spasticity: Mechanisms and Management , 1994 .

[16]  Richard M. Murray,et al.  A Mathematical Introduction to Robotic Manipulation , 1994 .

[17]  W. Rymer,et al.  Abnormal muscle coactivation patterns during isometric torque generation at the elbow and shoulder in hemiparetic subjects. , 1995, Brain : a journal of neurology.

[18]  J R Engsberg,et al.  Quantitative clinical measure of spasticity in children with cerebral palsy. , 1996, Archives of physical medicine and rehabilitation.

[19]  Evidence for task dependent weakness due to abnormal torque synergies in the impaired upper limb of hemiparetic stroke subjects: preliminary results , 1996, Proceedings of 18th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[20]  P. Neilson,et al.  Spasticity and muscle contracture following stroke. , 1996, Brain : a journal of neurology.

[21]  M. Levin.  Interjoint coordination during pointing movements is disrupted in spastic hemiparesis. , 1996, Brain : a journal of neurology.

[22]  W. Rymer,et al.  Robotic devices for physical rehabilitation of stroke patients: fundamental requirements, target therapeutic techniques, and preliminary designs , 1996 .

[23]  D Bourbonnais,et al.  Performance of the 'unaffected' upper extremity of elderly stroke patients. , 1996, Stroke.

[24]  J. B. Green,et al.  Neurologic Rehabilitation , 1997, Neurology.

[25]  N. Hogan,et al.  The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke. , 1997, Archives of neurology.

[26]  David J. Reinkensmeyer,et al.  Using a mechanical guide to evaluate and treat workspace deficits after brain injury , 1997, Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 'Magnificent Milestones and Emerging Opportunities in Medical Engineering' (Cat. No.97CH36136).

[27]  N. Hogan,et al.  Robot-aided neurorehabilitation. , 1998, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[28]  N. Hogan,et al.  Rehabilitators, Robots, and Guides: New Tools for Neurological Rehabilitation , 2000 .

[29]  Aaas News,et al.  Book Reviews , 1893, Buffalo Medical and Surgical Journal.