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Using Robotics to Quantify Impairments in Sensorimotor Ability, Visuospatial Attention, Working Memory, and Executive Function After Traumatic Brain Injury

Logan, Lindsey M., BScH; Semrau, Jennifer A., PhD; Debert, Chantel T., MD, MSc; Kenzie, Jeffrey M., BSc; Scott, Stephen H., PhD; Dukelow, Sean P., MD, PhD

The Journal of Head Trauma Rehabilitation: July/August 2018 - Volume 33 - Issue 4 - p E61–E73
doi: 10.1097/HTR.0000000000000349
Focus on Clinical Research and Practice

Objective: To investigate the use of a robotic assessment tool to quantify sensorimotor, visuospatial attention, and executive function impairments in individuals with traumatic brain injury (TBI).

Setting: Foothills Hospital (Calgary, Canada).

Participants: Twenty-three subjects with first-time TBI in the subacute to chronic phase participated in this study. Normative data were collected from 275 to 494 neurologically intact control subjects for each robotic task.

Design: A prospective observational case series. Subjects with TBI completed brief clinical cognitive and motor assessments followed by robotic assessments of upper limb reaching, position sense, bimanual motor ability, attention, and visuospatial skills. Scores of subjects with TBI were compared with normative data.

Main Measures: Robotic task performance was computed for each subject on each task, as well as performance on specific task parameters. Clinical assessments included the Montreal Cognitive Assessment, Fugl-Meyer upper extremity assessment, and Purdue Peg Board.

Results: Subjects with TBI demonstrated a variety of deficits on robotic tasks. The proportion of TBI subjects who were significantly different from controls ranged from 36% (dominant arm reaching) to 60% (bimanual object hitting task).

Conclusion: Robotic measures allowed us to quantify a range of impairments specific to each subject, and offer an objective tool with which to examine these abilities after TBI.

Faculty of Kinesiology (Ms Logan and Dr Dukelow), Hotchkiss Brain Institute (Drs Semrau, Debert, and Dukelow and Mr Kenzie), and Clinical Neurosciences, Cumming School of Medicine (Drs Debert and Dukelow), University of Calgary, Alberta, Canada; and Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada (Dr Scott).

Corresponding Author: Sean P. Dukelow, MD, PhD, Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada (

We would like to thank Mark Piitz, Janice Yajure, Megan Metzler, Justin Peterson, and Helen Bretzke for their technical assistance and support.

This research was made possible by a project grant from Canadian Institutes of Health Research (CIHR, MOP 106662). Lindsey Logan was supported by an Alberta Innovates Health Solutions summer studentship.

Stephen H. Scott is the creator of the KINARM exoskeleton robot, which is built by BKIN Technologies Ltd. He remains the Chief Scientific Officer for BKIN Technologies Ltd. The remaining authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

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