The clinical evaluation of the upper limb of severely impaired stroke patient is challenging. Sensor-based assessments may allow for an objective evaluation of this patient population. This study investigated the validity of a device-assisted approach in comparison to the clinical outcome that it is supposed to reflect. In nineteen severely impaired chronic stroke patients, we applied a gravity-compensating, multi-joint arm exoskeleton (Armeo Spring) and compared this sensor-based assessment with the clinical outcome measure Upper Extremity Fugl-Meyer Assessment (UE-FMA) scale. Specifically, we assessed separately and subsequently the range of motion in joint space for four single joints (i.e., wrist, elbow and shoulder flexion/extension (FE), and shoulder internal/external rotation (IER)), and the closing and opening of the hand with a pressure sensor placed in the handle. Within the kinematic parameters, a strong correlation was observed between wrist and elbow FE (r > 0.7, p < 0.003; Bonferroni corrected). The UE-FMA was significantly predicted by a multiple regression model (F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83). Both shoulder IER and grip pressure added significantly (p < 0.05) to the prediction with the standardized coefficients β of 0.55 and 0.38, respectively. By applying an exoskeleton-based self-contained evaluation of single-joint movements, a clinically valid assessment of the upper limb range of motion in severely impaired stroke patients is feasible. Shoulder IER contributed most relevantly to the prediction of the clinical status. These findings need to be confirmed in a large, independent patient cohort.

中文翻译：

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使用多关节臂外骨骼对中风后上肢运动进行运动学评估的临床验证

严重受损中风患者上肢的临床评估具有挑战性。基于传感器的评估可允许对该患者群体进行客观评估。本研究调查了器械辅助方法与其应该反映的临床结果相比的有效性。在 19 名严重受损的慢性中风患者中，我们应用了重力补偿、多关节手臂外骨骼 (Armeo Spring)，并将这种基于传感器的评估与临床结果测量上肢 Fugl-Meyer 评估 (UE-FMA) 量表进行了比较。具体来说，我们分别评估了四个单关节（即腕、肘和肩屈/伸 (FE) 和肩内/外旋 (IER)）在关节空间中的运动范围，以及在手柄中放置压力传感器的手的关闭和打开。在运动学参数中，手腕和肘部 FE 之间观察到很强的相关性（r > 0.7，p < 0.003；Bonferroni 校正）。UE-FMA 被多元回归模型显着预测（F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83）。肩部 IER 和握力压力都显着增加（p < 0.05），标准化系数 β 分别为 0.55 和 0.38。通过应用基于外骨骼的单关节运动独立评估，对严重受损的中风患者的上肢运动范围进行临床上有效的评估是可行的。肩部 IER 对临床状态的预测贡献最大。这些发现需要在一个大的、