Development of methods for evaluating functional gains in hemiplegic reaching and grasping

The research focuses on the development and validation of assessment methods for evaluating the changes in the sensory motor systems. For studying effects of neurorehabilitation it is essential to apply non or minimally invasive, reproducible measures of the changes within the sensory motor systems. Existing methods for evaluation of recovery relate to the assessment of disability and impairment, and only superficially to the gains in functioning that are of importance for daily life activities. Two outcome measures will be validated: The Upper Extremity Function Test (UEFT) for assessing of the gains in functioning, and the Drawing Test (DT) for evaluating the changes in the coordination between the proximal and distal segments of the paretic arm. The validation consists of determining correlation between the results from conventional assessment tests of impairment and disability (e.g., Fugl-Meyer, Ashworth scale) and scores from the UEFT and DT. The tests will be further used to compare the difference in hemiplegic patients subjected to FET or other treatment before and after the therapy. The second part of the project relates to the sensory motor systems. The assessment can be approached by using several methods: 1) activating cortical structures (Transcranial Magnetic Stimulation - TMS) and recordings from the peripheral systems, 2) stimulating peripheral structures and analysing reflex responses; 3) recording from the cortical structures (EEG and/or MEG) and correlating this activity with sensory cues and motor activities. We will look at EEG and evoked potentials in relation to specific sensory cues and motor activities. The initial phase is the development of the automatic analysis of the EEG recordings and testing of the procedures in able-bodied subjects. The specific tasks are related to the analysis of the premotor and motor cortex activities during the execution of the skills and newly acquired motor activities. Funded by the Danish National Research Foundation. (Dejan Popovic, Mirjana Popovic, Thomas Sinkjær, Clemens Eder, Kim Dremstrup Nielsen; Institute for Rehabilitation ?Dr Miroslav Zotovic?, Belgrade, FRY)