quantitative 3d kinematic analysis of upper extremity in...
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Quantitative 3D kinematic analysis of upper extremity in stroke
Margit Alt Murphy PhD, Reg. Physiotherapist
Inst. for Neuroscience and Physiology Sahlgrenska Academy
Gothenburg University, Sweden
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Kinematics Describes movements in space and time
Movement velocity and duration – 71% Movement smoothness – 58% Joint angles and trunk displacement – ca 50%
Most common measures in UE
Optoelectronic camera systems - 83% Electro-magnetic systems - 17% Ultrasounds systems - only few studies
Most common technologies used
Alt Murphy et al. PT Reviews 2015
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Kinematic analysis of the upper extremity after stroke
Alt Murphy, Häger C. Kinematic analysis of the upper extremity after stroke - How far have we reached and what have we grasped?
Physiotherapy Reviews 2015, in press
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Opto-electronic systems
ARMLAB 5 camera system
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3-D animation Normal movement
pattern Movement pattern
after stroke
head
Hand path
shoulder
hand
head
hand
shoulder
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Stroke
Healthy
Velocity profiles
Movement time: 6s Movement units: 4
Movement time: 16s Movement units: 35
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Alt Murphy 2013
What should we measure?
Principal Component Analysis - PCA
95% of the total variance was explained by
two major conceptual
measurement constructs
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ARAT Act ion
Research Arm Test
Movement smoothness
(Movement time)
Compensatory trunk
displacement
67%
37% 11%
Alt Murphy et al. NNR 2012, 26(9):1106-1115
Association with clinical instruments Kinematics
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Alt Murphy et al. NNR 2013
• Movement time • Smoothness • Trunk displacement are responsive measures
RESPONSIVENESS Change in kinematics was compared to the clinical improvement in ARAT ≥ 6 points (10%) - ROC curve analysis - Regression analysis
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Conclusions
Movement time Smoothness
Trunk displacement
Movement time is strongly correlated
with movement quality - smoothness
Trunk displacement summarizes well the
compensatory movement patterns
Clinically valid, reliable and responsive kinematic measures
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Action Research Arm Test (ARAT) correlates strongly with kinematics
Recommendations Purposeful functional tasks Select valid, reliable and responsive kinematics: • Movement time
• Smoothness • Movement pattern: trunk
displacement
Timed standardized testing provides indirect information of movement quality
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Acknowledgments Rehabilitation Medicine Research Group
Prof. Katharina S Sunnerhagen
Main funding Norrbacka-Eugenia Foundation
The Local Research and Development board National Stroke Association Swedish Research Council