Validation of a robot serious game assessment protocol for upper limb motor impairment in children with cerebral palsy.

BACKGROUND: The ROBiGAME project aims to implement serious games on robots to rehabilitate upper limb (UL) motor function in children with cerebral palsy (CP). Serious game characteristics (target position, level of assistance/resistance, level of force) are typically adapted based on the child's assessment before and continuously during the game (measuring UL working area, kinematics and muscle strength). OBJECTIVE: This study developed an UL robotic motor assessment protocol to configure the serious game. METHODS: Forty-nine healthy children and 20 CP children participated in the study. The clinical assessment consisted of the child's UL length and isometric force. The robot assessment consisted of the child's UL working area (WA), the UL isometric and isokinetic force in three directions and the UL kinematics during a pointing task toward targets placed at different distances. RESULTS: Results showed that WA and UL isometric force were moderately to highly correlated with clinical measures. Ratios between the UL isokinetic force generated on three directions were established. The velocity and straightness indexes of all children increased when they had to reach to targets placed more distant. CONCLUSIONS: This protocol can be integrated into different serious games in order to continuously configure the game characteristics to a child's performance. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT02543424), 12 August 2015.

Development of a robotic upper limb assessment to configure a serious game.

BACKGROUNDROBiGAME project aims to implement serious games on robots to rehabilitate upper limb (UL) in stroke patients. The serious game characteristics (target position, level of assistance/resistance, level of force) are adapted based on the patient's assessment before and continuously during the game (measuring UL working area, kinematics and muscle strength).OBJECTIVETo develop an UL robotic motor assessment protocol to configure the serious game.METHODS32 healthy subjects and 20 stroke patients participated in the study. Subjects were clinically assessed (UL length and isometric force) and using a robot. The robot assessment consisted of the patient's UL working area (WA), the UL isometric and isokinetic force in three directions and the UL kinematics during a pointing task toward targets placed at different distances.RESULTSThe WA and the UL isometric force were moderately to highly correlated with clinical measures (respectively ρ= 0.52; p = 0.003, ρ= 0.68-0.73; p < 0.001). Ratios between the UL isokinetic force generated on three directions were established. The velocity and straightness indexes of all subjects increased when subjects had to reach to targets placed more distantly (r= 0.82-0.90; ρ= 0.86-0.90 respectively; p < 0.001).CONCLUSIONSThis protocol can be integrated into a serious game in order to continuously configure the game characteristics to patient's performance.

Robot Diagnosis Test for Egocentric and Allocentric Hemineglect.

OBJECTIVE: Patients with hemineglect fail to respond to egocentric stimuli or allocentric parts of stimuli contralateral to the brain lesion. The clinical diagnosis of hemineglect mainly involves evaluation of the egocentric form, while less sensitive standardized tests exist for other forms. Our global aim is to develop an innovative integrative robot measure, the MonAmour test, combining the assessment of egocentric, allocentric and motor hemineglect. Here, we present the egocentric and allocentric evaluations. METHODS: Thirty-five first stroke patients (25 hemineglect) and 56 age-matched healthy controls were assessed on the index test (MonAmour) and on three reference standard tests (Bells test, Apples test and Neglect subtest of the Test for Attentional Performance). Based on controls' performance, normative data were created. Validity was evaluated between the MonAmour and the reference standard tests through correlations and test sensitivity/specificity. Reliability of the MonAmour was measured with test-retest and minimal detectable change. RESULTS: Results demonstrated moderate to strong correlations between the MonAmour and the reference standard tests (r = .40-.88, p < .001 - p = .016). The sensitivity was high (50%-96%), with accurate diagnosis of patients with hemineglect, and reliability was excellent (Intraclass Correlation Coefficient = .79-.95, p < .001). CONCLUSIONS: The MonAmour robot test is a valid, sensitive and reliable tool that can diagnose egocentric and allocentric hemineglect. Future studies will deepen the assessment and understanding of the different forms of hemineglect by testing the motor component of the test in order to use this accurate and integrative measure in daily clinical routine. REGISTRATION: ClinicalTrials.gov(NCT02543424).