Consistency evaluation of iKcare<sup>?</sup> grading system and Brunnstrom staging on motor function of upper and lower extremities in stroke patients_West China Medical Journal

Authors：

ZHAO Kehong ^1,2 , WANG Tingting ^1,2 ,  QU Yun ^1,2

1. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

QU Yun, Email: dr_yunqu@163.com

Keywords：

Stroke; remote rehabilitation; Brunnstrom staging; rehabilitation assessment

DOI：

10.7507/1002-0179.202204114

Video：

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Objective To explore the consistency between the iKcare^? grading system and Brunnstrom staging in evaluating upper and lower limb motor function in stroke patients. Methods From May 2018 to May 2020, stroke patients who met the standards in 34 medical institutions in China were recruited. The iKcare^? grading system and Brunnstrom staging were used to evaluate the motor function of the upper and lower limbs of the subjects, respectively. The Kappa consistency test was used to evaluate the consistency between the two evaluation methods. Results A total of 340 eligible subjects were included, including 230 males and 110 females, with an average age of (61.44±12.77) years old, and an average course of disease of (62.96±42.53) days. The results showed that the Kappa evaluated for upper limb staging was 0.597 (P<0.001), and the Kappa evaluated for lower limb staging was 0.514 (P<0.001). Conclusions The evaluation results of iKcare^? grading and Brunnstrom staging have moderate consistency. The iKcare^? grading system can be used as an assessment tool for remote rehabilitation of motor function in stroke patients, but there is still room for improvement.

Citation： ZHAO Kehong, WANG Tingting, QU Yun. Consistency evaluation of iKcare^? grading system and Brunnstrom staging on motor function of upper and lower extremities in stroke patients. West China Medical Journal, 2023, 38(5): 694-697. doi: 10.7507/1002-0179.202204114 Copy

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3.	Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in china: results from a nationwide population-based survey of 480?687 adults. Circulation, 2017, 135(8): 759-771.
4.	《中國腦卒中防治報告 2018》編寫組. 我國腦卒中防治仍面臨巨大挑戰—《中國腦卒中防治報告 2018》概要. 中國循環雜志, 2019, 34(2): 105-119.
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6.	Defebvre L, Krystkowiak P. Movement disorders and stroke. Rev Neurol (Paris), 2016, 172(8/9): 483-487.
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9.	陳穎. 腦卒中經濟負擔研究方法及應用進展. 預防醫學, 2019, 31(6): 578-581, 585.
10.	Dellifraine JL, Dansky KH. Home-based telehealth: a review and meta-analysis. J Telemed Telecare, 2008, 14(2): 62-66.
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14.	Chen J, Jin W, Zhang XX, et al. Telerehabilitation approaches for stroke patients: systematic review and meta-analysis of randomized controlled trials. J Stroke Cerebrovasc Dis, 2015, 24(12): 2660-2668.
15.	中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國腦出血診治指南(2014). 中華神經科雜志, 2015, 48(6): 435-444.
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19.	王玉龍. 康復功能評定學. 北京: 人民衛生出版社, 2015: 379-382.
20.	閆巖, 華琳, 張建. 對診斷一致性 kappa 系數及評價指標的探討. 中國衛生統計, 2007, 24(3): 313-315.
21.	Lin KH, Chen CH, Chen YY, et al. Bidirectional and multi-user telerehabilitation system: clinical effect on balance, functional activity, and satisfaction in patients with chronic stroke living in long-term care facilities. Sensors (Basel), 2014, 14(7): 12451-12466.
22.	Held JP, Ferrer B, Mainetti R, et al. Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system. Eur J Phys Rehabil Med, 2018, 54(4): 545-553.
23.	王躍, 郁磊, 傅建明, 等. 基于極限學習機的腦卒中上肢康復 Brunnstrom 遠程智能評定系統. 生物醫學工程學雜志, 2014, 31(2): 251-256.
24.	李靜, 余茜. 成都市社區腦卒中后遺癥期患者跌倒情況調查及相關因素分析. 中國康復醫學雜志, 2020, 35(1): 69-72.
25.	劉洪紅, 都天慧, 王婷婷, 等. 遠程康復設備梯度式運動功能自動評定系統在腦卒中患者中的應用. 中國醫療器械雜志, 2018, 42(2): 88-91.
26.	Lee SI, Adans-Dester CP, O’Brien AT, et al. Predicting and monitoring upper-limb rehabilitation outcomes using clinical and wearable sensor data in brain injury survivors. IEEE Trans Biomed Eng, 2021, 68(6): 1871-1881.
27.	王景麗, 李亮, 郁磊, 等. 基于遺傳算法和極限學習機的 Fugl-Meyer 量表自動評估. 計算機應用, 2014, 34(3): 907-910, 914.

1. Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet, 2014, 383(9913): 245-254.
2. Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
3. Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in china: results from a nationwide population-based survey of 480?687 adults. Circulation, 2017, 135(8): 759-771.
4. 《中國腦卒中防治報告 2018》編寫組. 我國腦卒中防治仍面臨巨大挑戰—《中國腦卒中防治報告 2018》概要. 中國循環雜志, 2019, 34(2): 105-119.
5. Rathore SS, Hinn AR, Cooper LS, et al. Characterization of incident stroke signs and symptoms: findings from the atherosclerosis risk in communities study. Stroke, 2002, 33(11): 2718-2721.
6. Defebvre L, Krystkowiak P. Movement disorders and stroke. Rev Neurol (Paris), 2016, 172(8/9): 483-487.
7. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol, 2009, 8(8): 741-754.
8. 王英, 龍納, 王鳳英, 等. 腦卒中患者社區康復現狀及我國實踐探索. 實用醫院臨床雜志, 2019, 16(4): 276-279.
9. 陳穎. 腦卒中經濟負擔研究方法及應用進展. 預防醫學, 2019, 31(6): 578-581, 585.
10. Dellifraine JL, Dansky KH. Home-based telehealth: a review and meta-analysis. J Telemed Telecare, 2008, 14(2): 62-66.
11. Tchero H, Tabue Teguo M, Lannuzel A, et al. Telerehabilitation for stroke survivors: systematic review and meta-analysis. J Med Internet Res, 2018, 20(10): e10867.
12. Cramer SC, Dodakian L, Le V, et al. Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke: a randomized clinical trial. JAMA Neurol, 2019, 76(9): 1079-1087.
13. Chen J, Jin W, Dong WS, et al. Effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia: a randomized controlled trial. Am J Phys Med Rehabil, 2017, 96(3): 152-160.
14. Chen J, Jin W, Zhang XX, et al. Telerehabilitation approaches for stroke patients: systematic review and meta-analysis of randomized controlled trials. J Stroke Cerebrovasc Dis, 2015, 24(12): 2660-2668.
15. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國腦出血診治指南(2014). 中華神經科雜志, 2015, 48(6): 435-444.
16. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性腦卒中診治指南 2018. 中華神經科雜志, 2018, 51(9): 666-682.
17. 孟琳, 都天慧, 范晶晶, 等. 基于微型傳感器的可穿戴遠程康復設備的設計. 中國醫療器械雜志, 2017, 41(3): 189-192.
18. Dong L, Wu J, Bao X. A hybrid hmm/kalman filter for tracking hip angle in gait cycle. IEICE Trans Inf Syst, 2006, 89(7): 2319-2323.
19. 王玉龍. 康復功能評定學. 北京: 人民衛生出版社, 2015: 379-382.
20. 閆巖, 華琳, 張建. 對診斷一致性 kappa 系數及評價指標的探討. 中國衛生統計, 2007, 24(3): 313-315.
21. Lin KH, Chen CH, Chen YY, et al. Bidirectional and multi-user telerehabilitation system: clinical effect on balance, functional activity, and satisfaction in patients with chronic stroke living in long-term care facilities. Sensors (Basel), 2014, 14(7): 12451-12466.
22. Held JP, Ferrer B, Mainetti R, et al. Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system. Eur J Phys Rehabil Med, 2018, 54(4): 545-553.
23. 王躍, 郁磊, 傅建明, 等. 基于極限學習機的腦卒中上肢康復 Brunnstrom 遠程智能評定系統. 生物醫學工程學雜志, 2014, 31(2): 251-256.
24. 李靜, 余茜. 成都市社區腦卒中后遺癥期患者跌倒情況調查及相關因素分析. 中國康復醫學雜志, 2020, 35(1): 69-72.
25. 劉洪紅, 都天慧, 王婷婷, 等. 遠程康復設備梯度式運動功能自動評定系統在腦卒中患者中的應用. 中國醫療器械雜志, 2018, 42(2): 88-91.
26. Lee SI, Adans-Dester CP, O’Brien AT, et al. Predicting and monitoring upper-limb rehabilitation outcomes using clinical and wearable sensor data in brain injury survivors. IEEE Trans Biomed Eng, 2021, 68(6): 1871-1881.
27. 王景麗, 李亮, 郁磊, 等. 基于遺傳算法和極限學習機的 Fugl-Meyer 量表自動評估. 計算機應用, 2014, 34(3): 907-910, 914.

West China Medical Journal

Consistency evaluation of iKcare^? grading system and Brunnstrom staging on motor function of upper and lower extremities in stroke patients

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West China Medical Journal

Consistency evaluation of iKcare? grading system and Brunnstrom staging on motor function of upper and lower extremities in stroke patients

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Consistency evaluation of iKcare^? grading system and Brunnstrom staging on motor function of upper and lower extremities in stroke patients