Force-based assessment captures unseen changes in normal and abnormal arm motion

Abstract

The whole repertoire of complex human motion is enabled by forces applied by our muscles and controlled by the nervous system. The of stroke on the complex multi-joint motor control is difficult to quantify in a meaningful way that informs about the underlying deficit in the active motor control and intersegmental coordination. We tested the idea that post-stroke deficit can be quantified with high sensitivity using motion capture and inverse modeling of a broad range of reaching movements. Our hypothesis is that muscle moments estimated based on active joint torques provide a more sensitive measure of post-stroke motor deficits than joint angle and angular velocity. The motion of twenty-two participants was captured while performing reaching movements in a center-out task, presented in virtual reality. We used inverse dynamics analysis to derive active joint torques that were the result of muscle contractions, termed muscle torques, that caused the recorded multi-joint motion. We then applied a novel analysis to separate the component of muscle torque related to gravity compensation from that related to intersegmental dynamics. Our results show that individual reaching movements can be characterized with higher information content using muscle torques rather than joint angles. Moreover, muscle torques allow for distinguishing between the individual motor deficits due to aging or stroke from the typical differences in reaching between healthy individuals. This novel quantitative assessment method may be used in conjunction with home-based gaming motion-capture technology for remote monitoring of motor deficits and inform the development of evidence-based robotic therapy interventions. New and NoteworthyFunctional deficits seen in task performance have biomechanical underpinnings, seen only through the analysis of forces. Our study has shown that estimating muscle moments can quantify with high sensitivity post-stroke deficits in intersegmental coordination. An assessment developed based on this method could help quantify less observable deficits in mildly affected stroke patients. It may also bridge the gap between evidence from studies of constrained or robotically manipulated movements and research with functional and unconstrained movements.