The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application
Abstract Background Assistive hand exoskeletons are promising tools to restore hand function after cervical spinal cord injury (SCI) but assessing their specific impact on bimanual hand and arm function is limited due to lack of reliable and valid clinical tests. Here, we introduce the Berlin Bimanu...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-023-01137-4 |
| _version_ | 1811175943789608960 |
|---|---|
| author | Cornelius Angerhöfer Mareike Vermehren Annalisa Colucci Marius Nann Peter Koßmehl Andreas Niedeggen Won-Seok Kim Won Kee Chang Nam-Jong Paik Volker Hömberg Surjo R. Soekadar |
| author_facet | Cornelius Angerhöfer Mareike Vermehren Annalisa Colucci Marius Nann Peter Koßmehl Andreas Niedeggen Won-Seok Kim Won Kee Chang Nam-Jong Paik Volker Hömberg Surjo R. Soekadar |
| author_sort | Cornelius Angerhöfer |
| collection | DOAJ |
| description | Abstract Background Assistive hand exoskeletons are promising tools to restore hand function after cervical spinal cord injury (SCI) but assessing their specific impact on bimanual hand and arm function is limited due to lack of reliable and valid clinical tests. Here, we introduce the Berlin Bimanual Test for Tetraplegia (BeBiTT) and demonstrate its psychometric properties and sensitivity to assistive hand exoskeleton-related improvements in bimanual task performance. Methods Fourteen study participants with subacute cervical SCI performed the BeBiTT unassisted (baseline). Thereafter, participants repeated the BeBiTT while wearing a brain/neural hand exoskeleton (B/NHE) (intervention). Online control of the B/NHE was established via a hybrid sensorimotor rhythm-based brain-computer interface (BCI) translating electroencephalographic (EEG) and electrooculographic (EOG) signals into open/close commands. For reliability assessment, BeBiTT scores were obtained by four independent observers. Besides internal consistency analysis, construct validity was assessed by correlating baseline BeBiTT scores with the Spinal Cord Independence Measure III (SCIM III) and Quadriplegia Index of Function (QIF). Sensitivity to differences in bimanual task performance was assessed with a bootstrapped paired t-test. Results The BeBiTT showed excellent interrater reliability (intraclass correlation coefficients > 0.9) and internal consistency (α = 0.91). Validity of the BeBiTT was evidenced by strong correlations between BeBiTT scores and SCIM III as well as QIF. Wearing a B/NHE (intervention) improved the BeBiTT score significantly (p < 0.05) with high effect size (d = 1.063), documenting high sensitivity to intervention-related differences in bimanual task performance. Conclusion The BeBiTT is a reliable and valid test for evaluating bimanual task performance in persons with tetraplegia, suitable to assess the impact of assistive hand exoskeletons on bimanual function. |
| first_indexed | 2024-04-10T19:45:17Z |
| format | Article |
| id | doaj.art-7ab3dfcc423043f4b6f6a406eefae345 |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-04-10T19:45:17Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-7ab3dfcc423043f4b6f6a406eefae3452023-01-29T12:06:02ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032023-01-0120111110.1186/s12984-023-01137-4The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton applicationCornelius Angerhöfer0Mareike Vermehren1Annalisa Colucci2Marius Nann3Peter Koßmehl4Andreas Niedeggen5Won-Seok Kim6Won Kee Chang7Nam-Jong Paik8Volker Hömberg9Surjo R. Soekadar10Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Neurowissenschaftliches Forschungszentrum (NWFZ), Charité-Universitätsmedizin BerlinClinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Neurowissenschaftliches Forschungszentrum (NWFZ), Charité-Universitätsmedizin BerlinClinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Neurowissenschaftliches Forschungszentrum (NWFZ), Charité-Universitätsmedizin BerlinClinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Neurowissenschaftliches Forschungszentrum (NWFZ), Charité-Universitätsmedizin BerlinKliniken Beelitz GmbHKliniken Beelitz GmbHDepartment of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalDepartment of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalDepartment of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalSRH Gesundheitszentrum Bad Wimpfen GmbHClinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Neurowissenschaftliches Forschungszentrum (NWFZ), Charité-Universitätsmedizin BerlinAbstract Background Assistive hand exoskeletons are promising tools to restore hand function after cervical spinal cord injury (SCI) but assessing their specific impact on bimanual hand and arm function is limited due to lack of reliable and valid clinical tests. Here, we introduce the Berlin Bimanual Test for Tetraplegia (BeBiTT) and demonstrate its psychometric properties and sensitivity to assistive hand exoskeleton-related improvements in bimanual task performance. Methods Fourteen study participants with subacute cervical SCI performed the BeBiTT unassisted (baseline). Thereafter, participants repeated the BeBiTT while wearing a brain/neural hand exoskeleton (B/NHE) (intervention). Online control of the B/NHE was established via a hybrid sensorimotor rhythm-based brain-computer interface (BCI) translating electroencephalographic (EEG) and electrooculographic (EOG) signals into open/close commands. For reliability assessment, BeBiTT scores were obtained by four independent observers. Besides internal consistency analysis, construct validity was assessed by correlating baseline BeBiTT scores with the Spinal Cord Independence Measure III (SCIM III) and Quadriplegia Index of Function (QIF). Sensitivity to differences in bimanual task performance was assessed with a bootstrapped paired t-test. Results The BeBiTT showed excellent interrater reliability (intraclass correlation coefficients > 0.9) and internal consistency (α = 0.91). Validity of the BeBiTT was evidenced by strong correlations between BeBiTT scores and SCIM III as well as QIF. Wearing a B/NHE (intervention) improved the BeBiTT score significantly (p < 0.05) with high effect size (d = 1.063), documenting high sensitivity to intervention-related differences in bimanual task performance. Conclusion The BeBiTT is a reliable and valid test for evaluating bimanual task performance in persons with tetraplegia, suitable to assess the impact of assistive hand exoskeletons on bimanual function.https://doi.org/10.1186/s12984-023-01137-4TetraplegiaExoskeletonBimanual task performanceBrain–computer interface (BCI)Clinical assessmentAssistive robotics |
| spellingShingle | Cornelius Angerhöfer Mareike Vermehren Annalisa Colucci Marius Nann Peter Koßmehl Andreas Niedeggen Won-Seok Kim Won Kee Chang Nam-Jong Paik Volker Hömberg Surjo R. Soekadar The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application Journal of NeuroEngineering and Rehabilitation Tetraplegia Exoskeleton Bimanual task performance Brain–computer interface (BCI) Clinical assessment Assistive robotics |
| title | The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application |
| title_full | The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application |
| title_fullStr | The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application |
| title_full_unstemmed | The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application |
| title_short | The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application |
| title_sort | berlin bimanual test for tetraplegia bebitt development psychometric properties and sensitivity to change in assistive hand exoskeleton application |
| topic | Tetraplegia Exoskeleton Bimanual task performance Brain–computer interface (BCI) Clinical assessment Assistive robotics |
| url | https://doi.org/10.1186/s12984-023-01137-4 |
| work_keys_str_mv | AT corneliusangerhofer theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT mareikevermehren theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT annalisacolucci theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT mariusnann theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT peterkoßmehl theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT andreasniedeggen theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT wonseokkim theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT wonkeechang theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT namjongpaik theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT volkerhomberg theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT surjorsoekadar theberlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT corneliusangerhofer berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT mareikevermehren berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT annalisacolucci berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT mariusnann berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT peterkoßmehl berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT andreasniedeggen berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT wonseokkim berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT wonkeechang berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT namjongpaik berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT volkerhomberg berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication AT surjorsoekadar berlinbimanualtestfortetraplegiabebittdevelopmentpsychometricpropertiesandsensitivitytochangeinassistivehandexoskeletonapplication |