Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke
ObjectiveThe objective of this study is to verify the reliability and the concurrent and discriminant validity of the measurements of spasticity offered by the robotic device, quantifying the (1) test–retest reliability, (2) correlation with the clinical evaluation using the Modified Ashworth Scale...
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| Format: | Article |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Neurorobotics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnbot.2023.1172770/full |
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| author | Rocío Urrutia Rocío Urrutia Ane Miren Gutiérrez-Muto Clara B. Sanz-Morère Clara B. Sanz-Morère Arantxa Gómez Angela M. Politi Francesca Lunardini Marco Baccini Francesca Cecchi Francesca Cecchi Natacha León Antonio Oliviero Jesús Tornero |
| author_facet | Rocío Urrutia Rocío Urrutia Ane Miren Gutiérrez-Muto Clara B. Sanz-Morère Clara B. Sanz-Morère Arantxa Gómez Angela M. Politi Francesca Lunardini Marco Baccini Francesca Cecchi Francesca Cecchi Natacha León Antonio Oliviero Jesús Tornero |
| author_sort | Rocío Urrutia |
| collection | DOAJ |
| description | ObjectiveThe objective of this study is to verify the reliability and the concurrent and discriminant validity of the measurements of spasticity offered by the robotic device, quantifying the (1) test–retest reliability, (2) correlation with the clinical evaluation using the Modified Ashworth Scale (MAS), (3) inter-rater reliability between the two physiotherapists, and (4) ability to discriminate between healthy and stroke patients.MethodsA total of 20 stroke patients and 20 healthy volunteers participated in the study. Two physical therapists (PT1 and PT2) independently evaluated the hand spasticity of stroke subjects using the MAS. Spasticity was assessed, both in healthy and stroke patients, with the Amadeo device at three increasing velocities of passive movement for three consecutive repeated assessments, while raw data of force and position were collected through an external program.Data analysisThe intraclass correlation coefficient (ICC) and the weighted kappa were computed to estimate the reliability of the Amadeo device measurements, the inter-rater reliability of MAS, and the correlation between the MAS and Amadeo device measurements. The discriminant ability of the Amadeo device was assessed by comparing the stroke and healthy subjects' spasticity measurements with the percentage of agreements with 0 in MAS for healthy subjects.ResultsThe test–retest reliability of the Amadeo device was high with ICC at all three velocities (ICC = 0.908, 0.958, and 0.964, respectively) but lower if analyzed with weighted kappa correlation (0.584, 0.748, and 0.749, respectively) as mean values for each velocity. The correlation between Amadeo and the clinical scale for stroke patients with weighted kappa correlation was poor (0.280 ± 0.212 for PT1 and 0.290 ± 0.155 for PT2). The inter-rater reliability of the clinical MAS was high (ICC = 0.911).ConclusionBoth MAS and Amadeo spasticity scores showed good reliability. The Amadeo scores did not show a strong clinical correlation with the MAS in stroke patients. Hitherto, Amadeo evaluation shows trends that are consistent with the characteristics of spasticity, such as an increase in spasticity as the speed of muscle stretching increases. The ability of the device to discriminate between stroke patients and healthy controls is low. Future studies adopting an instrumental gold standard for spasticity may provide further insight into the validity of these measurements. |
| first_indexed | 2024-03-13T01:11:11Z |
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| language | English |
| last_indexed | 2024-03-13T01:11:11Z |
| publishDate | 2023-07-01 |
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| series | Frontiers in Neurorobotics |
| spelling | doaj.art-e77fe5ceb5974bd99ebec159b09adbb32023-07-05T22:31:15ZengFrontiers Media S.A.Frontiers in Neurorobotics1662-52182023-07-011710.3389/fnbot.2023.11727701172770Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric strokeRocío Urrutia0Rocío Urrutia1Ane Miren Gutiérrez-Muto2Clara B. Sanz-Morère3Clara B. Sanz-Morère4Arantxa Gómez5Angela M. Politi6Francesca Lunardini7Marco Baccini8Francesca Cecchi9Francesca Cecchi10Natacha León11Antonio Oliviero12Jesús Tornero13Center for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainJoint PhD Program in Neuroscience, University of Castilla La Mancha, Albacete, SpainCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainNeural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, SpainCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainFondazione Don Carlo Gnocchi, Scientific Institute, Florence, ItalyCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainFondazione Don Carlo Gnocchi, Scientific Institute, Florence, ItalyFondazione Don Carlo Gnocchi, Scientific Institute, Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, Florence, ItalyCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainCenter for Clinical Neuroscience, Hospital Los Madroños, Madrid, SpainObjectiveThe objective of this study is to verify the reliability and the concurrent and discriminant validity of the measurements of spasticity offered by the robotic device, quantifying the (1) test–retest reliability, (2) correlation with the clinical evaluation using the Modified Ashworth Scale (MAS), (3) inter-rater reliability between the two physiotherapists, and (4) ability to discriminate between healthy and stroke patients.MethodsA total of 20 stroke patients and 20 healthy volunteers participated in the study. Two physical therapists (PT1 and PT2) independently evaluated the hand spasticity of stroke subjects using the MAS. Spasticity was assessed, both in healthy and stroke patients, with the Amadeo device at three increasing velocities of passive movement for three consecutive repeated assessments, while raw data of force and position were collected through an external program.Data analysisThe intraclass correlation coefficient (ICC) and the weighted kappa were computed to estimate the reliability of the Amadeo device measurements, the inter-rater reliability of MAS, and the correlation between the MAS and Amadeo device measurements. The discriminant ability of the Amadeo device was assessed by comparing the stroke and healthy subjects' spasticity measurements with the percentage of agreements with 0 in MAS for healthy subjects.ResultsThe test–retest reliability of the Amadeo device was high with ICC at all three velocities (ICC = 0.908, 0.958, and 0.964, respectively) but lower if analyzed with weighted kappa correlation (0.584, 0.748, and 0.749, respectively) as mean values for each velocity. The correlation between Amadeo and the clinical scale for stroke patients with weighted kappa correlation was poor (0.280 ± 0.212 for PT1 and 0.290 ± 0.155 for PT2). The inter-rater reliability of the clinical MAS was high (ICC = 0.911).ConclusionBoth MAS and Amadeo spasticity scores showed good reliability. The Amadeo scores did not show a strong clinical correlation with the MAS in stroke patients. Hitherto, Amadeo evaluation shows trends that are consistent with the characteristics of spasticity, such as an increase in spasticity as the speed of muscle stretching increases. The ability of the device to discriminate between stroke patients and healthy controls is low. Future studies adopting an instrumental gold standard for spasticity may provide further insight into the validity of these measurements.https://www.frontiersin.org/articles/10.3389/fnbot.2023.1172770/fullmuscle spasticitymuscle tonerehabilitationstrokeAmadeoupper limb |
| spellingShingle | Rocío Urrutia Rocío Urrutia Ane Miren Gutiérrez-Muto Clara B. Sanz-Morère Clara B. Sanz-Morère Arantxa Gómez Angela M. Politi Francesca Lunardini Marco Baccini Francesca Cecchi Francesca Cecchi Natacha León Antonio Oliviero Jesús Tornero Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke Frontiers in Neurorobotics muscle spasticity muscle tone rehabilitation stroke Amadeo upper limb |
| title | Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke |
| title_full | Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke |
| title_fullStr | Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke |
| title_full_unstemmed | Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke |
| title_short | Spasticity evaluation with the Amadeo Tyromotion device in patients with hemispheric stroke |
| title_sort | spasticity evaluation with the amadeo tyromotion device in patients with hemispheric stroke |
| topic | muscle spasticity muscle tone rehabilitation stroke Amadeo upper limb |
| url | https://www.frontiersin.org/articles/10.3389/fnbot.2023.1172770/full |
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