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- Alt Murphy, Margit, 1970, et al.
(författare)
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Early prediction of upper limb functioning after stroke using clinical bedside assessments: a prospective longitudinal study.
- 2022
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Early and accurate prediction of recovery is needed to assist treatment planning and inform patient selection in clinical trials. This study aimed to develop a prediction algorithm using a set of simple early clinical bedside measures to predict upper limb capacity at 3-months post-stroke. A secondary analysis of Stroke Arm Longitudinal Study at Gothenburg University (SALGOT) included 94 adults (mean age 68 years) with upper limb impairment admitted to stroke unit). Cluster analysis was used to define the endpoint outcome strata according to the 3-months Action Research Arm Test (ARAT) scores. Modelling was carried out in a training (70%) and testing set (30%) using traditional logistic regression, random forest models. The final algorithm included 3 simple bedside tests performed 3-days post stroke: ability to grasp, to produce any measurable grip strength and abduct/elevate shoulder. An 86-94% model sensitivity, specificity and accuracy was reached for differentiation between poor, limited and good outcome. Additional measurement of grip strength at 4 weeks post-stroke and haemorrhagic stroke explained the underestimated classifications. External validation of the model is recommended. Simple bedside assessments have advantages over more lengthy and complex assessments and could thereby be integrated into routine clinical practice to aid therapy decisions, guide patient selection in clinical trials and used in data registries.
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- Alt Murphy, Margit, 1970, et al.
(författare)
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Kinematic analysis using 3D motion capture of drinking task in people with and without upper-extremity impairments
- 2018
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Ingår i: Journal of Visualized Experiments. - : MyJove Corporation. - 1940-087X. ; :133
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Tidskriftsartikel (refereegranskat)abstract
- Kinematic analysis is a powerful method for objective assessment of upper extremity movements in a three-dimensional (3D) space. Three-dimensional motion capture with an optoelectronic camera system is considered as golden standard for kinematic movement analysis and is increasingly used as outcome measure to evaluate the movement performance and quality after an injury or disease involving upper extremity movements. This article describes a standardized protocol for kinematic analysis of drinking task applied in individuals with upper extremity impairments after stroke. The drinking task incorporates reaching, grasping and lifting a cup from a table to take a drink, placing the cup back, and moving the hand back to the edge of the table. The sitting position is standardized to the individual's body size and the task is performed in a comfortable self-paced speed and compensatory movements are not constrained. The intention is to keep the task natural and close to a real-life situation to improve the ecological validity of the protocol. A 5-camera motion capture system is used to gather 3D coordinate positions from 9 retroreflective markers positioned on anatomical landmarks of the arm, trunk, and face. A simple single marker placement is used to ensure the feasibility of the protocol in clinical settings. Custom-made Matlab software provides automated and fast analyses of movement data. Temporal kinematics of movement time, velocity, peak velocity, time of peak velocity, and smoothness (number of movement units) along with spatial angular kinematics of shoulder and elbow joint as well as trunk movements are calculated. The drinking task is a valid assessment for individuals with moderate and mild upper extremity impairment. The construct, discriminative and concurrent validity along with responsiveness (sensitivity to change) of the kinematic variables obtained from the drinking task have been established. © 2018 Journal of Visualized Experiments.
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- Alt Murphy, Margit, 1970, et al.
(författare)
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Kinematic Variables Quantifying Upper-Extremity Performance After Stroke During Reaching and Drinking From a Glass.
- 2011
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Ingår i: Neurorehabilitation and Neural Repair. - : SAGE Publications. - 1552-6844 .- 1545-9683. ; 25:1, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: . Three-dimensional kinematic analysis provides quantitative and qualitative assessment of upper-limb motion and is used as an outcome measure to evaluate impaired movement after stroke. The number of kinematic variables used, however, is diverse, and models for upper-extremity motion analysis vary. OBJECTIVE: . The authors aim to identify a set of clinically useful and sensitive kinematic variables to quantify upper-extremity motor control during a purposeful daily activity, that is, drinking from a glass. METHODS: . For this purpose, 19 participants with chronic stroke and 19 healthy controls reached for a glass of water, took a sip, and placed it back on a table in a standardized way. An optoelectronic system captured 3-dimensional kinematics. Kinematical parameters describing movement time, velocity, strategy and smoothness, interjoint coordination, and compensatory movements were analyzed between groups. RESULTS: . The majority of kinematic variables showed significant differences between study groups. The number of movement units, total movement time, and peak angular velocity of elbow discriminated best between healthy participants and those with stroke as well as between those with moderate (Fugl-Meyer scores of 39-57) versus mild (Fugl-Meyer scores of 58-64) arm impairment. In addition, the measures of compensatory trunk and arm movements discriminated between those with moderate and mild stroke impairment. CONCLUSION: . Kinematic analysis in this study identified a set of movement variables during a functional task that may serve as an objective assessment of upper-extremity motor performance in persons who can complete a task, such as reaching and drinking, after stroke.
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- Alt Murphy, Margit, 1970, et al.
(författare)
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Movement deficits in the ipsilesional “less-affected” arm after stroke. Part of the Stroke Arm Longitudinal study at Gothenburg University, SALGOT-study
- 2016
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Ingår i: Neurorehabilitation and Neural Repair. - 1545-9683.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives Increasing body of literature indicates that motor function at the ipsilesional side after stroke can be affected, but these deficits can be difficult to detect using traditional clinical scales. In addition, the ipsilesional side is commonly used as reference, representing a normal movement in assessments, which may affect the test results. The study aims to determine whether and to what extent the movements in the ipsilesional upper limb are affected after stroke. Methods In total, 44 individuals with stroke and 20 healthy controls were included. An optoelectronic motion capture system was used to measure kinematics and Fugl-Meyer Assessment for Upper Extremity to assess sensorimotor impairment in to subgroups (moderate 32-57, mild 58-66). Kinematic measures describing movement time, velocity, smoothness, strategy and compensatory movements in drinking task at two time points, early during the first month and at 3 months after stroke, were analyzed. Results The entire stroke group showed ipsilesional deficits in 6 and the subgroup of moderate impairment in 9 of the 12 kinematic measures early after stroke. In moderate impairment group the movements were slower, less smooth, the deceleration phase was longer and a larger abduction of the arm was used during drinking activity compared to healthy controls. A statistically significant improvement was also detected over time in 6 kinematic measures, but a deficit was still present in angular velocity of elbow and deceleration time in reaching 3 months poststroke. Conclusions This study demonstrates that motor deficits are common in ipsilesional upper extremity early after stroke and these deficits are more prominent in persons with poor controlesional motor function. The ipsilesional arm should be assessed early after stroke, preferably using measures that are sensitive to detect minor deficits. Clinical scales using the “less-affected” arm as reference, indicating normal movement, should be used with caution early after stroke.
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- Alt Murphy, Margit, 1970, et al.
(författare)
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Movement kinematics during a drinking task are associated with the activity capacity level after stroke.
- 2012
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Ingår i: Neurorehabilitation and neural repair. - : SAGE Publications. - 1552-6844 .- 1545-9683. ; 26:9, s. 1106-15
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Tidskriftsartikel (refereegranskat)abstract
- Kinematic analysis is a powerful method for an objective assessment of movements and is increasingly used as an outcome measure after stroke. Little is known about how the actual movement performance measured with kinematics is related to the common traditional assessment scales. The aim of this study was to determine the relationships between movement kinematics from a drinking task and the impairment or activity limitation level after stroke.
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