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Guidance-based quantification of arm impairment following brain injury: a pilot study.

This paper reports the design and preliminary testing of a device for evaluating arm impairment after brain injury. The assisted rehabilitation and measurement (ARM) Guide is capable of mechanically guiding reaching and retrieval movements across the workspace and of measuring constraint forces and range of motion during guidance. We tested the device on four hemiplegic brain-injured individuals and four unimpaired control subjects. During guided movement, the brain-injured subjects generated distinct spatial patterns of constraint force with their impaired arms that were consistent with the standard flexion and extension "synergies" described in the clinical literature. In addition, the impaired arms exhibited well-defined workspace deficits as measured by the ARM Guide. These results suggest that constraint force and range of motion measurements during mechanically guided movement may prove useful for precise monitoring of arm impairment and of the effects of treatment techniques targeted at abnormal synergies and workspace deficits.