Dataset Information

Adaptive Staircase Measurement of Hand Proprioception.

ABSTRACT: Clinicians and researchers often need to measure proprioception (position sense), for example to monitor the progress of disease, to identify the cause of movement or balance problems, or to ascertain the effects of an intervention. While researchers can use sophisticated equipment to estimate proprioceptive acuity with good precision, clinicians lack this option and must rely on the subjective and imprecise methods currently available in the clinic. Here we describe a novel technique that applies psychometric adaptive staircase procedures to hand proprioception with a simple tablet-style apparatus that could easily be adapted for the clinic. We report test-retest reliability, inter-rater reliability, and construct validity of the adaptive staircase method vs. two other methods that are commonly used in clinical settings: passive motion direction discrimination (PMDD) and matching. As a first step, we focus on healthy adults. Subjects ages 18-82 had their proprioception measured with each of the three techniques, at the metacarpophalangeal joint in the second finger of the right hand. A subset completed a second session in which the measures were repeated, to assess test-retest reliability. Another subset had the measurements done by two different testers to assess inter-rater reliability. Construct validity was assessed using stepwise regression on age and activity level, and correlations calculated across the three methods. Results suggest that of the three methods, the adaptive staircase method yields the best test-retest reliability, inter-rater reliability, and construct validity. The adaptive staircase method may prove to be a valuable clinical tool where more accurate assessment of proprioception is needed.

SUBMITTER: Hoseini N

PROVIDER: S-EPMC4537315 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Adaptive Staircase Measurement of Hand Proprioception.

Hoseini Najmeh N Sexton Brandon M BM Kurtz Karl K Liu Yang Y Block Hannah J HJ

PloS one 20150814 8

Clinicians and researchers often need to measure proprioception (position sense), for example to monitor the progress of disease, to identify the cause of movement or balance problems, or to ascertain the effects of an intervention. While researchers can use sophisticated equipment to estimate proprioceptive acuity with good precision, clinicians lack this option and must rely on the subjective and imprecise methods currently available in the clinic. Here we describe a novel technique that appli ...[more]

PMID: 26274824

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Project description:The overarching goal was to resolve a major barrier to real-life prosthesis usability-the rapid degradation of prosthesis control systems, which require frequent recalibrations. Specifically, we sought to develop and test a motor decoder that provides (1) highly accurate, real-time movement response, and (2) unprecedented adaptability to dynamic changes in the amputee's biological state, thereby supporting long-term integrity of control performance with few recalibrations. To achieve that, an adaptive motor decoder was designed to auto-switch between algorithms in real-time. The decoder detects the initial aggregate motoneuron spiking activity from the motor pool, then engages the optimal parameter settings for decoding the motoneuron spiking activity in that particular state. "Clear-box" testing of decoder performance under varied physiological conditions and post-amputation complications was conducted by comparing the movement output of a simulated prosthetic hand as driven by the decoded signal vs. as driven by the actual signal. Pearson's correlation coefficient and Normalized Root Mean Square Error were used to quantify the accuracy of the decoder's output. Our results show that the decoder algorithm extracted the features of the intended movement and drove the simulated prosthetic hand accurately with real-time performance (<10 ms) (Pearson's correlation coefficient >0.98 to >0.99 and Normalized Root Mean Square Error <13-5%). Further, the decoder robustly decoded the spiking activity of multi-speed inputs, inputs generated from reversed motoneuron recruitment, and inputs reflecting substantial biological heterogeneity of motoneuron properties, also in real-time. As the amputee's neuromodulatory state changes throughout the day and the electrical properties and ratio of slower vs. faster motoneurons shift over time post-amputation, the motor decoder presented here adapts to such changes in real-time and is thus expected to greatly enhance and extend the usability of prostheses.

Project description:Background. Hand function is essential to a person's self-efficacy and greatly affects quality of life. Adapted utensils with handles of increased diameters have historically been used to assist individuals with arthritis or other hand disabilities for feeding, and other related activities of daily living. To date, minimal research has examined the biomechanical effects of modified handles, or quantified the differences in ranges of motion (ROM) when using a standard versus a modified handle. The aim of this study was to quantify the ranges of motion (ROM) required for a healthy hand to use different adaptive spoons with electrogoniometry for the purpose of understanding the physiologic advantages that adapted spoons may provide patients with limited ROM. Methods. Hand measurements included the distal interphalangeal joint (DIP), proximal interphalangeal joint (PIP), and metacarpophalangeal joint (MCP) for each finger and the interphalangeal (IP) and MCP joint for the thumb. Participants were 34 females age 18-30 (mean age 20.38 ± 1.67) with no previous hand injuries or abnormalities. Participants grasped spoons with standard handles, and spoons with handle diameters of 3.18 cm (1.25 inch), and 4.45 cm (1.75 inch). ROM measurements were obtained with an electrogoniometer to record the angle at each joint for each of the spoon handle sizes. Results. A 3 × 3 × 4 repeated measures ANOVA (Spoon handle size by Joint by Finger) found main effects on ROM of Joint (F(2, 33) = 318.68, Partial ? (2) = .95, p < .001), Spoon handle size (F(2, 33) = 598.73, Partial ? (2) = .97, p < .001), and Finger (F(3, 32) = 163.83, Partial ? (2) = .94, p < .001). As the spoon handle diameter size increased, the range of motion utilized to grasp the spoon handle decreased in all joints and all fingers (p < 0.01). Discussion. This study confirms the hypothesis that less range of motion is required to grip utensils with larger diameter handles, which in turn may reduce challenges for patients with limited ROM of the hand.

Dataset Information

Adaptive Staircase Measurement of Hand Proprioception.

Publications

Adaptive Staircase Measurement of Hand Proprioception.

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