The feasibility of measuring rehabilitation-induced changes in upper limb movement and cognition using robotic kinematics in chronic stroke

Background: Robotic measurement of kinematics is a potential method to detect precise rehabilitation-induced changes in upper limb movement and cognition post-stroke. To what degree robot-derived data aligns with other gold-standard upper limb measurement tools has yet to be described. Such comparisons would be important for translating such tools to research and clinical practice. Methods: Using the Kinesiological Instrument for Normal and Altered Reaching Movement (Kinarm), we compared the relationship between robot-derived values and gold-standard clinical tests of upper limb performance and cognitive function before and after a rehabilitation intervention in patients with chronic stroke. The intervention involved 10 sessions of pairing aerobic exercise with skilled motor and cognitive practice. Participants underwent motor performance and cognitive function assessments using the Kinarm endpoint robot and standardized measurement scales at baseline, after the 10 intervention sessions and 30 days later. Results: Ten participants with chronic upper limb impairment due to stroke (69.4 ± 12.9 years old: 7 males, 3 females) completed the intervention sessions. There were no significant improvements in upper limb recovery when measured using the clinical gold-standard tests. However, robotic kinematics variables showed significant changes in motor performance at follow-up. There were no significant changes in cognitive measures pre- and post-rehabilitation intervention. Conclusion: Rehabilitation-induced changes in upper limb performance and cognitive changes may be effectively detected and quantified using robotic kinematics measures