Assessing Cognitive, Sensory, and Motor Function in Multiple Sclerosis Using Kinarm Robotics System
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Authors
Mastantuono, Isabelle J.
Date
Type
thesis
Language
eng
Keyword
Kinarm , Neuroscience , Multiple Sclerosis , Cognitive-Motor Interference
Alternative Title
Abstract
Multiple Sclerosis (MS) is a chronic neuroinflammatory disorder characterized by multifocal inflammation and demyelination throughout the central nervous system, leading to
widespread motor, cognitive, and/or sensory dysfunction. The current gold standard for assessing disability progression in MS is the Expanded Disability Status Scale (EDSS), ranging from 0, a
normal neurological exam, to 10, signifying death due to MS (Kurtzke, 1983). Yet, this disability scale predominantly focuses on mobility and lower limb motor function with a limited assessment of upper limb function and cognition (Bethoux et al., 2016). Importantly, the EDSS lacks the evaluation of complex tasks involving simultaneous cognitive and motor function.
In this study, we use the Kinarm robotic platform to evaluate upper limb sensory, motor, and cognitive function in Persons with MS (PwMS) and compare it to standard clinical assessments. We hypothesize that individuals with MS will exhibit greater impairments in complex tasks involving cognitive and motor processing, and there will be a strong correlation in performance across robot-based and traditional variants of related tasks. This research builds upon the previous Kinarm feasibility study conducted by our group (Simmatis et al., 2020), with a larger combined cohort of 65 patients with EDSS scores ranging from 0 to 4 (mild to moderate impairments). PwMS complete traditional clinical assessments in addition to 7 Kinarm Standard Tests (KST) including 1) basic sensory and motor performance and 2) complex dual processing cognitive-motor tasks.
Our results identified 64.6% (42/65) of PwMS as impaired on at least one task. Basic motor tasks revealed impairment rates ranging from 12.3% to 16.92%, whereas complex tasks with additional cognitive challenges exhibited higher impairment rates from 21.5% to 30.7%. Concurrent validity was established through moderate correlations and consistent levels of impairment between the Kinarm assessments and the traditional clinical assessments. Importantly, these findings highlight the limitations of the EDSS in capturing cognitive and motor impairments in more complex tasks that do not align with the expected disability progression suggested by the EDSS. This study highlights the Kinarm’s ability to quantify a range of cognitive and motor
impairments in PwMS.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.