Comparative analysis of upper body kinematics in stroke, Parkinson's disease, and healthy subjects: An observational study using IMU-based targeted box and block test

• Published in: Gait & posture Vol. 114; pp. 69 - 77
• Main Authors: Cocco, Elena Sofia, Pournajaf, Sanaz, Romano, Paola, Morone, Giovanni, Thouant, Carrie-Louise, Buscarini, Leonardo, Manzia, Carlotta Maria, Cioeta, Matteo, Felzani, Giorgio, Infarinato, Francesco, Franceschini, Marco, Goffredo, Michela
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.10.2024
• Subjects: Adult; Aged; Biomechanical Phenomena; Box and Block test; Case-Control Studies; Female; Healthy Volunteers; Humans; Kinematic data; Male; Middle Aged; Parkinson Disease - physiopathology; Parkinson Disease - rehabilitation; Parkinson’s disease; Stroke; Stroke - physiopathology; Stroke Rehabilitation - methods; Upper Extremity - physiopathology; Upper limb rehabilitation; Box and Block test; Upper limb rehabilitation; Stroke; Parkinson’s disease; Kinematic data
• ISSN: 0966-6362; 1879-2219; 1879-2219
• DOI: 10.1016/j.gaitpost.2024.09.002

The Box and Block Test (BBT) is an essential and widely used test in rehabilitation for the assessment of gross unilateral manual dexterity. Although it is a valid, simple, and ecological instrument, it does not provide a quantitative measure of the upper limb trajectories during the test. The study introduces a new motion-capture-based method (using ecological Inertial Measurement Units - IMUs) to evaluate upper body kinematics while performing a targeted version of BBT (tBBT). This observational study compares data from 35 healthy subjects, 35 subjects with Parkinson’s disease, and 35 post-stroke individuals to evaluate upper limb kinematics during tBBT quantitatively. Seven IMUs were placed on the trunk, head, and upper limb of each subject. The joint angles and kinematic scores were calculated and analyzed. Motor task execution time and kinematic scores were statistically correlated with clinical assessment measures. Kruskal-Wallis between groups test and Dunn-Bonferroni post-hoc were used. The statistics revealed significant differences (p<0.05) among the three groups. The analyzed joint angles highlight various compensatory strategies in neurological subjects, such as using the trunk to complete a motor task instead of the shoulder and using the wrist instead of the elbow, along with differences in movement fluidity (DimensionLess-Jerk, p<0.05). A positive correlation was found between kinematics and the Fugl-Meyer Assessment-Upper Limb (r=0.7344; p<0.01), and a negative correlation between kinematics and the Unified Parkinson's Disease Rating Scale (r=-0.5286; p<0.01). The quantitative assessments of joint kinematics correlated to clinical assessments could guarantee a new method of assessment of the upper limb in subjects with motor deficits. This would allow to capture new insight into the characteristics of the subject’s disability, with implications for the choice of a personalized rehabilitation treatment focused on the motor recovery of the upper limb. •An innovative version of the Box and Block Test can be utilized for an instrumental assessment of upper limb function.•Upper limb kinematics’ analysis allows the evaluation of compensatory strategies.•Neurological diseases significantly affect upper extremity motor function patterns.•Kinematics parameters are correlated to the clinical assessment measures.