Literature review of stroke assessment for upper-extremity physical function via EEG, EMG, kinematic, and kinetic measurements and their reliability.
Rene M Maura, Sebastian Rueda Parra, Richard E Stevens and 3 others
PMID 36793077WHAT IT FOUND
Robotic sensors can measure upper-limb movement more precisely than clinical scales, but they are not yet ready for routine use.
Biomechanical data is reliable, while brain and muscle signals lack consistent reliability data for stroke patients.
Key findings
01Traditional clinical scales like the Fugl-Meyer are reliable but lack sensitivity to small changes, especially at the extremes of impairment.
02Biomechanical metrics such as range of motion and speed show good to excellent repeatability, but evidence for consistency between different therapists is limited.
03EEG and EMG measures show promise for predicting recovery but have not been sufficiently tested for reliability in stroke patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review excluded studies prior to 2000, potentially missing earlier foundational reliability data. Many included studies did not report the specific ICC model or confidence intervals required to fully judge their reliability. Reliability data for electrophysiological metrics (EEG/EMG) in stroke patients is extremely limited, with many conclusions drawn from studies on healthy controls or other populations. The review did not assess the validity of these metrics against each other, only their relationship to standard clinical scales.
Declared interests
The authors declared no competing interests. The work was supported by the National Science Foundation and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The easy way to misread this
Do not assume that because a robotic metric correlates with a clinical score, it is reliable enough for patient monitoring. The review found that many promising neural metrics lack test-retest reliability data in stroke patients, meaning a change in score could reflect measurement error rather than patient recovery.