Upper Limb Muscle Strength Models for Patients With Motor Impairment.

Pôle Saint Hélier32 enrolled

Overview

Upper limb motor impairments are common. They affect quality of life and can lead to dependency. They are mainly due to neurological conditions such as stroke, multiple sclerosis, and traumatic spinal cord injury. However, the contractile properties of muscle, in particular the maximum force that can be generated voluntarily (MVF) depending on joint angle and motion speed, have been mainly studied and modeled in healthy people. This study aims at developing mathematical models describing residual muscle forces in patients with motor impairments. The knowledge could guide patients' rehabilitation and could be useful for the development of robotic assistance systems that use patients\' residual capacities to control the level of assistance provided.

Study Type

INTERVENTIONAL

Allocation

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Conditions

Stroke Multiple Sclerosis Spinal Cord Injuries

Interventions

Upper limb isokinetic forces measurementsOTHER

The trial is a single-center prospective interventional study. Patients aged 18 to 85 years hospitalized in a French rehabilitation center for stroke, multiple sclerosis or traumatic tetraplegia and presenting a motor deficit ≤3/5 at the shoulder and elbow will be included. MVF measurements will be performed using an isokinetic ergometer during a single session. Concentric and eccentric MVF, as well as the forces generated during passive motion, will be measured in shoulder external-internal rotation and in elbow flexion-extension, in the seated position. The demographic, anthropometric and medical data required for the study will be extracted from medical records. Patients' residual muscle strength will be described and modeled. Explanatory factors for model quality will be determined.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged between 18 and 85 * A patient who is a member or beneficiary of a social security scheme * Patients hospitalised at the Saint-Hélier rehabilitation centre for a stroke more than 15 days old, MS or SCI * Patients with a motor deficit ≤3/5 on the MRC (Medical Research Council) scale in both internal-external shoulder rotation and elbow flexion-extension. * Patient with voluntary consent to participate in this study. Exclusion Criteria: * Spasticity \>3/4 on the Aschworth scale in the shoulder abductor or elbow flexor muscles. * Cognitive impairment that may interfere with measurements (MOCA \< 20/30) * Presence of a pressure sore \> stage 2 at the ischial level * Recent trauma to limbs or spine * Decompensated heart disease or other unbalanced pathology which contraindicates or may hinder isokinetic testing. * Persons deprived of their liberty by a judicial or administrative decision * Pregnant women, women in labour or nursing mothers.

Outcomes

Primary Outcomes

Description of the residuals of the effort generation models, defined as the difference between the actual effort values and the modelled values: o Average residual of the models (mean ± standard deviation) (Main Evaluation Criterion)

Time frame: From enrollment to the end of the participation at maximum 7 days