Mapping upper-limb motor performance after stroke - a novel method with utility for individualized motor training.
Orna Rosenthal, Alan M Wing, Jeremy L Wyatt and 2 others
PMID 29208020WHAT IT FOUND
A robot-based reaching map identified individual upper-limb impairment patterns after chronic stroke and was used to select training movements.
In two adults, no controlled outcome tested whether this improves function.
Key findings
01The method mapped 64 reaching conditions, repeated 5 times (320 trials), usually in one session under one hour.
02The maps showed different impairment patterns in the two participants: participant 1 had dominant abnormally fast movements, while participant 2 had dominant slow movements and different impaired directions.
03The paper did not test whether this mapping method improves upper-limb motor performance; the randomized comparison is planned for a later report.
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
This report presents a mapping method and example maps, not a controlled test of treatment benefit. Training changes are shown for one participant only, so they cannot show that mapping-based selection caused improvement. The training included robot-assisted forces and gravity support, so the contribution of any single component cannot be separated. The maps are limited to short planar reaches in a horizontal plane, so they may not capture all everyday upper-limb movement. Robot assistance confounds usual kinematic measures, so the maps use assistance and guidance forces and selected performance measures. The authors state that the benefit of mapping-based individualized therapy still needs to be demonstrated. The paper does not report whether upper-limb function or daily activities improved. The participant count is not fully consistent: the methods state two adults, but a figure caption mentions participant 3.
Declared interests
Funded by the Medical Research Council and the Wellcome Trust. The supplied text does not list competing interests.
The easy way to misread this
Do not conclude that mapping-based robot training improves upper-limb function or daily activity. The paper reports method examples in two adults, training changes in one participant, and says the controlled comparison will be reported later.