The gap between clinical gaze and systematic assessment of movement disorders after stroke

J Neuroeng Rehabil. 2012 Aug 27:9:61. doi: 10.1186/1743-0003-9-61.

Abstract

Background: Movement disorders after stroke are still captured by clinical gaze and translated to ordinal scores of low resolution. There is a clear need for objective quantification, with outcome measures related to pathophysiological background. Neural and non-neural contributors to joint behavior should be separated using different measurement conditions (tasks) and standardized input signals (force, position and velocity).

Methods: We reviewed recent literature for the application of biomechanical and/or elektromyographical (EMG) outcome measures under various measurement conditions in clinical research.

Results: Since 2005, 36 articles described the use of biomechanical and/or EMG outcome measures to quantify post-stroke movement disorder. Nineteen of the articles strived to separate neural and non-neural components. Only 6 of the articles measured biomechanical and EMG outcome measures simultaneously, while applying active and passive tasks and multiple velocities.

Conclusion: The distinction between neural and non-neural components to separately assess paresis, stiffness and muscle overactivity is not commonplace yet, while a large gap is to be bridged to attain reproducible and comparable results. Pathophysiologically clear concepts, substantiated with a comprehensive and concise measuring protocol will help professionals to identify and treat limiting factors in movement capabilities of post-stroke patients.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Electromyography
  • Female
  • Fixation, Ocular / physiology*
  • Humans
  • Joints / physiopathology
  • Male
  • Movement Disorders / diagnosis*
  • Movement Disorders / etiology*
  • Muscle Tonus / physiology
  • Muscle, Skeletal / physiopathology
  • Paresis / physiopathology
  • Range of Motion, Articular
  • Stroke / complications*
  • Stroke / physiopathology*
  • Treatment Outcome
  • Viscosity