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

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

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  • 1Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, Netherlands. j.m.van_der_krogt@lumc.nl

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.

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