Quantification of motor performance in patients with impaired upper limb movements

There is growing need for accurate quantification of performance in patients with impaired upper limb movements. This arises from the need to assess recovery of movement following neurosurgery and stroke and to underpin a stratified approach to rehabilitation.
We have recently developed methods to assess upper limb movements in a 2D workspace, using the resulting "performance map" to guide stroke rehabilitation. We have also developed methods to link the patients' performance to muscle activation patterns. We now want to extend this work into 3D, to allow assessment of a broader range of movements, closer to normal activities, and in a shorter period of assessment. In addition, we wish to extend from stroke to assessment of functional recovery after neurosurgery, as a prelude to testing enhancement of recovery with brain stimulation: this would include patients with surgical repair of traumatic injury (road traffic accidents). Finally, we aim to extend our methods to link performance to muscle activation patterns in these continuous movements, in order to better understand the underlying deficits in motor control.
The project will make use of a state-of-the-art 3D robotic arm, and assess performance by developing a 3D tracking task, in which a subject's motor ability is progressively expanded from an initial slow and central focus to regions needing more extended limb postures and faster movement. An assistive algorithm in which the force-controlled robot guides movement towards the target will be used to help patients overcome weak and unstable movement, while still allowing assessment of performance speed, direction and stability.
Actions in the robot-assisted task will be compared with free movement tracking in a virtual reality environment, with limb movements captured by existing motion tracking systems, but this motion tracking will ultimately be possible with a device such as the Microsoft Wii or smartphone. The comparisons will inform the potential to translate the assessment from the lab based robotic systems to the bedside.
The outcome will be a set of diagnostic tests that deliver accurate quantification of upper limb movement control, suitable for triage of rehabilitation and for assessment of progressive recovery.