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Strokes are a leading cause of disability, with many experiencing difficultyin recovering arm movement, particularly hand function and grasping ability.There is currently no objective measure of movement quality, and without it,rehabilitative interventions remain at best estimations of the underlyingneural structures response to produce movement. In this paper, we utilize anovel modification to Procrustean distance to quantify curve dissimilarity andpropose the Reach Severity and Dissimilarity Index (RSDI) as an objectivemeasure of motor deficits. All experiments took place at the Medstar NationalRehabilitation Hospital; persons with stroke were recruited from the hospitalpatient population. Using Fugl-Meyer (FM) scores and reach capacities, strokesurvivors were placed in mild or severe impairment groups. Individualscompleted sets of reach-to-target tasks to extrapolate kinematic metricsdescribing motor performance. The Procrustes method of statistical shapeanalysis was modified to identify reaching sub-movements that were congruous toable-bodied sub-movements. Movement initiation proceeds comparably to thereference curve in two- and three-dimensional representations of mildimpairment movement. There were significant effects of the location ofcongruent segments between subject and reference curves, mean velocities, peakroll angle, and target error. These metrics were used to calculate apreliminary RSDI score with severity and dissimilarity sub-scores, and subjectswere reclassified in terms of rehabilitation goals as Speed Emphasis, StrengthEmphasis, and Combined Emphasis. The Modified Procrustes method shows promisein identifying disruptions in movement and monitoring recovery without addingto patient burden. The proposed RSDI score, while limited in scope, can beadapted and expanded to other functional movements and used as an objectiveclinical tool.

Upper extremity kinematics: Development of a quantitative measure of impairment severity and dissimilarity after stroke