Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.

Robotic devices are commonly used to quantify sensorimotor function of the upper limb after stroke; however, the availability and cost of such devices make it difficult to facilitate implementation in clinical environments. Tablets (e.g. iPad) can be used as devices to facilitate rehabilitation but...

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Main Authors: Devin Sean Austin, Makenna J Dixon, Joanna E Hoh, Duncan Thibodeau Tulimieri, Joshua G A Cashaback, Jennifer A Semrau
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0311773
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author Devin Sean Austin
Makenna J Dixon
Joanna E Hoh
Duncan Thibodeau Tulimieri
Joshua G A Cashaback
Jennifer A Semrau
author_facet Devin Sean Austin
Makenna J Dixon
Joanna E Hoh
Duncan Thibodeau Tulimieri
Joshua G A Cashaback
Jennifer A Semrau
author_sort Devin Sean Austin
collection DOAJ
description Robotic devices are commonly used to quantify sensorimotor function of the upper limb after stroke; however, the availability and cost of such devices make it difficult to facilitate implementation in clinical environments. Tablets (e.g. iPad) can be used as devices to facilitate rehabilitation but are rarely used as assessment tools for the upper limb. The current study aimed to implement a tablet-based Maze Navigation Task to examine complex upper-limb movement in individuals with chronic stroke. We define complex upper-limb movement as reaching movements that require multi-joint coordination in a dynamic environment. We predicted that individuals with stroke would have more significant spatial errors, longer movement times, and slower speeds compared to controls with increasing task complexity. Twenty individuals with chronic stroke who had a variety of arm and hand function (Upper extremity Fugl-Myer 52.8 ± 18.3) and twenty controls navigated eight pseudorandomized mazes on an iPad using a digitizing stylus. The task was designed to elicit reaching movements engaging both the shoulder and elbow joints. Each maze became increasingly complex by increasing the number of 90° turns. We instructed participants to navigate each maze as quickly and accurately as possible while avoiding the maze's boundaries. Sensorimotor behavior was quantified using the following metrics: Error Time (time spent hitting or outside boundaries), Peak Speed, Average Speed, and Movement Time, Number of Speed Peaks. We found that individuals with stroke had significantly greater Error Time for all maze levels (all, p < 0.01), while both speed metrics, Movement Time and Number of Speed Peaks were significantly lower for several levels (all, p < 0.05). As maze complexity increased, the performance of individuals with stroke worsened only for Error Time while control performance remained consistent (p < 0.001). Our results indicate that a complex movement task on a tablet can capture temporal and spatial impairments in individuals with stroke, as well as how task complexity impacts movement quality. This work demonstrates that a tablet is a suitable tool for the assessment of complex movement after stroke and can serve to inform rehabilitation after stroke.
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spelling doaj-art-9a0f4e4191374eaa8411d26c96a00f332024-11-21T05:30:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031177310.1371/journal.pone.0311773Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.Devin Sean AustinMakenna J DixonJoanna E HohDuncan Thibodeau TulimieriJoshua G A CashabackJennifer A SemrauRobotic devices are commonly used to quantify sensorimotor function of the upper limb after stroke; however, the availability and cost of such devices make it difficult to facilitate implementation in clinical environments. Tablets (e.g. iPad) can be used as devices to facilitate rehabilitation but are rarely used as assessment tools for the upper limb. The current study aimed to implement a tablet-based Maze Navigation Task to examine complex upper-limb movement in individuals with chronic stroke. We define complex upper-limb movement as reaching movements that require multi-joint coordination in a dynamic environment. We predicted that individuals with stroke would have more significant spatial errors, longer movement times, and slower speeds compared to controls with increasing task complexity. Twenty individuals with chronic stroke who had a variety of arm and hand function (Upper extremity Fugl-Myer 52.8 ± 18.3) and twenty controls navigated eight pseudorandomized mazes on an iPad using a digitizing stylus. The task was designed to elicit reaching movements engaging both the shoulder and elbow joints. Each maze became increasingly complex by increasing the number of 90° turns. We instructed participants to navigate each maze as quickly and accurately as possible while avoiding the maze's boundaries. Sensorimotor behavior was quantified using the following metrics: Error Time (time spent hitting or outside boundaries), Peak Speed, Average Speed, and Movement Time, Number of Speed Peaks. We found that individuals with stroke had significantly greater Error Time for all maze levels (all, p < 0.01), while both speed metrics, Movement Time and Number of Speed Peaks were significantly lower for several levels (all, p < 0.05). As maze complexity increased, the performance of individuals with stroke worsened only for Error Time while control performance remained consistent (p < 0.001). Our results indicate that a complex movement task on a tablet can capture temporal and spatial impairments in individuals with stroke, as well as how task complexity impacts movement quality. This work demonstrates that a tablet is a suitable tool for the assessment of complex movement after stroke and can serve to inform rehabilitation after stroke.https://doi.org/10.1371/journal.pone.0311773
spellingShingle Devin Sean Austin
Makenna J Dixon
Joanna E Hoh
Duncan Thibodeau Tulimieri
Joshua G A Cashaback
Jennifer A Semrau
Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.
PLoS ONE
title Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.
title_full Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.
title_fullStr Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.
title_full_unstemmed Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.
title_short Using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke.
title_sort using a tablet to understand the spatial and temporal characteristics of complex upper limb movements in chronic stroke
url https://doi.org/10.1371/journal.pone.0311773
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