Table 4.
Validity, reliability and responsiveness of robot-aided assessments of lower limb functions
| Measure | Instrument | Properties | Study and population tested | |||
|---|---|---|---|---|---|---|
| Validity | Inter-rater reliability | Intra-rater reliability | Responsiveness | |||
| pROM | Lokomat | - | - | - | - | - |
| Isokinetic dynamometer (Biodex System 3 Pro dynamometer - Biodex Medical Systems Inc., Shirley, NY, USA) | - | Ankle DF: ICC ≥ 0.938 SEM = 1.4° |
Ankle DF: ICC ≥ 0.930 SEM = 0.8° |
MDC = 2.2°-3.3° | [34], 15 stroke patients | |
| Manual spasticity evaluator | - | ρ = 0.95 | ICC = 0.86 | - | [45], 12 children with CP, 5 able-bodied (AB) adults | |
| Anklebot | Mean absolute error over two planes ≤1° | - | - | - | [49], validation vs electrogoniometer using a mock-up foot | |
| Ankle assessment device | - | - | Ankle DF: ICC = 0.846 Ankle PF: ICC = 0.958 |
Ankle DF: MDC = 3.27° Ankle PF: MDC = 3.81° |
[232], 9 AB subjects | |
| aROM | - | - | - | - | - | No studies found |
| Muscle strength | Isokinetic dynamometer (Biodex System 3) | - | - | Isometric peak torque control subjects: ICC ≥ 0.92; SEM ≤ 25.1 Nm Peak torque patients, contralesional limb ICC ≥ 0.86, SEM ≤ 23.9 Nm |
- | [90], 17 subjects with stroke, 13 AB subjects |
| Lokomat, isometric test | - | Hip: ICC ≥ 0.87, SEM ≤ 11.2 Nm; Knee: ICC ≥ 0.85, SEM ≤ 7.9 Nm. | Hip: ICC ≥ 0.79, SEM ≤ 10.5 Nm; Knee: ICC ≥ 0.84, SEM ≤ 8.2 Nm. | - | [10], 14 subjects with neurological movement disorders, 16 AB subjects | |
| Ankle assessment device | - | - | Ankle DF: ICC = 0.949 Ankle PF: ICC = 0.858 |
Ankle DF: MDC = 1.69 Nm Ankle PF: MDC = 1.68 Nm |
[232], 9 AB subjects | |
| Proprioception | Modified Biodex chair, TTDPM test | - | - | Knee frontal plane: ICC ≥ 0.40 | - | [104], 17 AB subjects |
| Chair with knee actuator, TTDPM test | - | OA: ICC = 0.91, SEM = 2.13°, AB: ICC = 0.89, SEM = 0.43° | OA: ICC = 0.91, SEM = 2.26°, AB: ICC = 0.86, SEM = 0.39° | - | [113] 24 subjects with OA, 26 AB subjects | |
| Lokomat, JPR test | vs clinical score: Hip: ρ = 0.507, Knee: ρ = 0.790 |
- | SCI, Hip: ICC = 0.55, Knee: ICC = 0.882 AB, Hip: ICC = 0.493, Knee: ICC = 0.656 |
- | [106], 23 SCI and 23 AB subjects | |
| Lokomat, TTDPM test | vs manual kinesthesia assessment: left hip, r = −0.71; left knee, r = −0.86; right hip, r = −0.47; right knee, r = −0.57 | - | AB, hip: ICC = 0.88 left, ICC = 0.94 right; knee ICC = 0.90 left, ICC = 0.91 right. SCI, hip: ICC = 0.97 left, ICC = 0.96 right; knee: ICC = 0.95 left, ICC = 0.96 right |
- | [114], 17 SCI and 17 AB subjects Manual kinesthesia assessment: 1 point for each correct movement detection |
|
| Abnormal joint synergies | - | - | - | - | - | No studies found |
| Passive ankle stiffness | Manual spasticity evaluator | - | Ankle DF 4°: r = 0.81 | Ankle DF 4°: ICC = 0.82 | - | [45], 12 children with CP |
| Ankle perturbator | Repeated testing of known static torque: ICC = 0.994 | ICC = 0.767-0.943 | - | - | [233], 10 AB subjects | |
| Ankle assessment device | - | - | Ankle DF 20°: ICC = 0.863 Ankle DF 30°: ICC = 0.865 |
Ankle DF 20°: MDC = 0.0686 Nm/° Ankle DF 30°: MDC = 0.1323 Nm/° |
[232], 9 AB subjects | |
| Active ankle stiffness | Ankle perturbator | - | - | r > 0.8 | - | [164], 11 AB subjects |
| Ankle perturbator | - | Between-trial: ICC = 0.76–0.99 and between-day: ICC = 0.64–0.95 | - | - | [165], 38 children with CP and 35 AB subjects | |
| Walking function/Gait pattern | Exosuit: strain sensors | Mean absolute error ≤ 8° | - | - | - | [61], 1 AB subject |
| Soft ankle orthosis: strain sensors, IMUs | Mean error strain sensor: 0.255 ± 1.63° Mean error IMUs: 0.135 ± 2.85° |
- | - | - | [204], 1 AB subject | |
ρ indicates Spearman’s rank correlation, r Pearson’s correlation, DF dorsiflexion, PF plantarflexion