Zariffa J, Myers M, Coahran M, Wang RH. Smallest real differences for robotic measures of upper extremity function after stroke: Implications for tracking recovery.
J Rehabil Assist Technol Eng 2018;
5:2055668318788036. [PMID:
31191947 PMCID:
PMC6453062 DOI:
10.1177/2055668318788036]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/14/2018] [Indexed: 01/23/2023] Open
Abstract
Introduction
Measurements from upper limb rehabilitation robots could guide therapy
progression, if a robotic assessment’s measurement error was small enough to
detect changes occurring on a time scale of a few days. To guide this
determination, this study evaluated the smallest real differences of robotic
measures, and of clinical outcome assessments predicted from these
measures.
Methods
A total of nine older chronic stroke survivors took part in 12-week study
with an upper-limb end-effector robot. Fourteen robotic measures were
extracted, and used to predict Fugl-Meyer Assessment-Upper Extremity
(FMA-UE) and Action Research Arm Test (ARAT) scores using multilinear
regression. Smallest real differences and intraclass correlation
coefficients were computed for the robotic measures and predicted clinical
outcomes, using data from seven baseline sessions.
Results
Smallest real differences of robotic measures ranged from 8.8% to 26.9% of
the available range. Smallest real differences of predicted clinical
assessments varied widely depending on the regression model (1.3 to 36.2 for
FMA-UE, 1.8 to 59.7 for ARAT), and were not strongly related to a model’s
predictive performance or to the smallest real differences of the model
inputs. Models with acceptable predictive performance as well as low
smallest real differences were identified.
Conclusions
Smallest real difference evaluations suggest that using robotic assessments
to guide therapy progression is feasible.
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