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End-point kinematics using virtual reality explaining upper limb impairment and activity capacity in stroke

Journal article
Authors Netha Hussain
Katharina S Sunnerhagen
Margit Alt Murphy
Published in Journal of NeuroEngineering and Rehabilitation
Volume 16
Issue 1
ISSN 1743-0003
Publication year 2019
Published at Institute of Neuroscience and Physiology
Language en
Keywords Kinematics, Outcome assessment, Stroke rehabilitation, Upper extremity movement, Virtual reality, adult, article, clinical evaluation, cohort analysis, confounding variable, controlled study, female, human, longitudinal study, major clinical study, male, movement time, multiple linear regression analysis, registration, upper limb, velocity
Subject categories Neurosciences


Background: For evaluation of upper limb impairment and activity capacity, Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) are recommended to be included in stroke trials. To improve the understanding of mechanisms of motor recovery, and differentiate between restitution and compensation, kinematic analysis is also recommended for assessment of upper limb function after stroke. Aim: To determine the extent to which end-point kinematic variables obtained from the target-to-target pointing task were associated with upper limb impairment or activity limitation as assessed by traditional clinical scales in individuals with stroke. Methods: Sixty-four individuals, from acute stage up to one year after stroke, were included from the Stroke Arm Longitudinal study at the University of Gothenburg (SALGOT) cohort. They performed a target-to-target pointing task in a virtual environment using a haptic stylus which also captured the kinematic parameters. Multiple linear regression was done to determine the amount of variance explained by kinematic variables on FMA-UE and ARAT scores after controlling for confounding variables. Results: Mean velocity and number of velocity peaks explained 11 and 9% of the FMA-UE score uniquely and 16% when taken together. Movement time and number of velocity peaks explained 13 and 10% of the ARAT score respectively. Conclusion: The kinematic variables of movement time, velocity and smoothness explain only a part of the variance captured by using clinical observational scales, reinforcing the importance of multi-level assessment using both kinematic analysis and clinical scales in upper limb evaluation after stroke. Trial registration: The trial was registered with register number NCT01115348 at, on May 4, 2010. URL: © 2019 The Author(s).

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