Article

Kinematic movement analysis is increasingly used as an outcome
measure in evaluation of upper extremity function after stroke. Little is known,
however, about what observed longitudinal changes in kinematics mean in the
context of an individual's functioning. In this study, the responsiveness and
expected change in kinematic measures associated with clinically meaningful
improvement in the upper extremity were evaluated. METHODS: . Kinematic movement
analysis of a drinking task and Action Research Arm Test (ARAT) were performed
early (9 days poststroke) and at 3 months after stroke in 51 subjects. The
receiver-operating characteristic curve and linear regression analyses were used
to evaluate responsiveness of kinematic parameters. RESULTS: Movement time,
smoothness, and trunk displacement discriminated those subjects demonstrating
clinically meaningful improvements. Significant associations of 31% to 36% were
found between the change in ARAT and kinematic measures. A real clinical
improvement in kinematics lies in the range of 2.5 to 5 seconds, 3 to 7 units,
and 2 to 5 cm in movement time, smoothness, and trunk displacement, respectively.
CONCLUSIONS: All kinematic measures reported in this study are responsive
measures for capturing improvements in the upper extremity during the first 3
months after stroke. Approximate estimates for the expected change in kinematics
associated with clinically meaningful improvement in upper extremity activity
capacity illustrate the usefulness of the linear regression analysis for
assessing responsiveness. This knowledge facilitates the selection of kinematic
measures for clinical and movement analysis research as well as for
technology-based devices.

Langue : ANGLAIS