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. 2024 May 29;21(1):90.
doi: 10.1186/s12984-024-01382-1.

Measurement properties of movement smoothness metrics for upper limb reaching movements in people with moderate to severe subacute stroke

Gwenaël Cornec  1   2 , Mathieu Lempereur  3   4 , Johanne Mensah-Gourmel  3   4   5 , Johanna Robertson  6 , Ludovic Miramand  4   5 , Beatrice Medee  3 , Soline Bellaiche  7 , Raphael Gross  8 , Jean-Michel Gracies  9   10 , Olivier Remy-Neris  3   4 , Nicolas Bayle  9   10
Affiliations

Measurement properties of movement smoothness metrics for upper limb reaching movements in people with moderate to severe subacute stroke

Gwenaël Cornec et al. J Neuroeng Rehabil. .

Abstract

Background: Movement smoothness is a potential kinematic biomarker of upper extremity (UE) movement quality and recovery after stroke; however, the measurement properties of available smoothness metrics have been poorly assessed in this group. We aimed to measure the reliability, responsiveness and construct validity of several smoothness metrics.

Methods: This ancillary study of the REM-AVC trial included 31 participants with hemiparesis in the subacute phase of stroke (median time since stroke: 38 days). Assessments performed at inclusion (Day 0, D0) and at the end of a rehabilitation program (Day 30, D30) included the UE Fugl Meyer Assessment (UE-FMA), the Action Research Arm Test (ARAT), and 3D motion analysis of the UE during three reach-to-point movements at a self-selected speed to a target located in front at shoulder height and at 90% of arm length. Four smoothness metrics were computed: a frequency domain smoothness metric, spectral arc length metric (SPARC); and three temporal domain smoothness metrics (TDSM): log dimensionless jerk (LDLJ); number of submovements (nSUB); and normalized average rectified jerk (NARJ).

Results: At D30, large clinical and kinematic improvements were observed. Only SPARC and LDLJ had an excellent reliability (intra-class correlation > 0.9) and a low measurement error (coefficient of variation < 10%). SPARC was responsive to changes in movement straightness (rSpearman=0.64) and to a lesser extent to changes in movement duration (rSpearman=0.51) while TDSM were very responsive to changes in movement duration (rSpearman>0.8) and not to changes in movement straightness (non-significant correlations). Most construct validity hypotheses tested were verified except for TDSM with low correlations with clinical metrics at D0 (rSpearman<0.5), ensuing low predictive validity with clinical metrics at D30 (non-significant correlations).

Conclusions: Responsiveness and construct validity of TDSM were hindered by movement duration and/or noise-sensitivity. Based on the present results and concordant literature, we recommend using SPARC rather than TDSM in reaching movements of uncontrolled duration in individuals with spastic paresis after stroke.

Trial registration: NCT01383512, https://clinicaltrials.gov/ , June 27, 2011.

Keywords: Kinematics; Measurement properties; Reaching; Smoothness; Stroke.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Marker placement (left) and 3D reconstruction (right) during motion analysis
Fig. 2
Fig. 2
Representation of the motion analysis set-up at the starting position
Fig. 3
Fig. 3
Trajectories and velocity profiles of day 0 (D0) and day 30 (D30) reaching movements. Blue line: mean value, lavender: standard deviation area
See this image and copyright information in PMC

References

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