The Reverse Visually Guided Reaching task is meant to assesses a subject’s attention, inhibitory control and cognitive control of visuomotor skills. During the task, the subject reaches the initial central target and in doing so, the movement of the cursor (white circle) representing hand position is mirror reversed relative to the central target (i.e. the visual feedback is reversed compared to the actual hand position). From there the task requires the subject to cognitively override the normal response to move the hand directly to a target and instead initiate a movement in the opposite direction.

Citation: The primary reference for the task’s development is Lowrey et al, 2022. Hawkins and Sergio 2015 found the task to be highly sensitive to subtle impairments and harbours the potential of identifying adults at risk of Alzheimer’s. 

The Object Hit and Avoid task is meant to assess spatial attention, rapid motor selection and inhibition control. At the start of the task the subject is shown 2 target shapes which the subject is instructed to memorize as the only shapes to hit during the task; they are instructed to avoid all other shapes or distractors (of which there are 6).

Citation: Bourke et al. 2016 concludes that the task is able to identify that many subjects with stroke have impairments in the rapid selection and generation of motor responses to task specific spatial goals in the workspace.

US Patent No. 8,740,794

Trail Making tests are commonly used cognitive tests from the field of neuropsychology to assess task switching abilities. The version implemented for the Kinarm Labs is similar to the standard pen and paper versions, but with additional measurement parameters and accuracy. There are two parts to the overall task. In the first part, the subject must trace through a sequence of targets numbered 1 to 25 as quickly as possible (Trail A). In the second part, the subject must trace through an alternating alpha-numeric sequence of targets 1-A-2-B etc. up to 13, again for a total of 25 targets (Trail B).

Citations: Bowie and Harvey 2006 and Corrigan and Hinkeldey 1987 discuss the utility of this classic test.

The Spatial Span test is a classic test of visuospatial working memory; it tests the component of working memory that enables one to temporarily hold and manipulate information about places. Like the Trail Making test, the Spatial Span test has been adapted for the Kinarm Lab to provide easy inclusion into a battery of tests. During each trial of the task, the subject must reach to a starting location, after which 12 squares are displayed in a 3×4 grid, and a sequence of those squares will light up in random order. The subject is instructed to replay the sequence by reaching and pausing at the appropriate squares. If the subject can correctly replay the sequence, then on the next trial the length of the sequence will increase by 1, up to a maximum of 12.

Citations: Berch, Krikorian and Huha 1998; Owens, Evans and Petrides 1996; Owens et al. 1995; Owens et al. 1990 provide further context for the utility of this classic test.

The Paired Associates Learning task is another classic test of visuospatial working memory that is meant measure a participant’s memory by testing their ability to associate patterns with spatial locations and recall them after a delay. Like the Trail Making test and the Spatial Span test, it has been adapted for the Kinarm Lab to provide easy inclusion into a battery of tests. During the task, images are shown in spatial locations and then hidden. Upon presentation of an image, the subject must indicate the spatial location of the hidden image.

*This task is available upon request without analysis (which will follow in Dex 3.10).

Citation: Calkins 1896 serves as the primary reference for the development of this classic test.

The Visually Guided Reaching task provides a measure of the subject’s visuomotor capabilities and multi-joint coordination. During this task, the subject is instructed to an initial central target. Once there, the subject is instructed to quickly and accurately move to a peripheral target that appears. This process is repeated a number of times both to explore the workspace and to measure variability in the subject’s responses.

Citation: Coderre et al. 2010 serves as the primary reference for the task. The paper concludes that the task can provide reliable information with greater sensitivity about a patient’s sensorimotor impairments following stroke when compared to a standard clinical assessment scale.

The Object Hit task is a rapid sensorimotor decision and control test. It was developed to objectively assess the ability of a subject to select and engage motor actions with both hands over a range of speeds and a large workspace, measuring both visuomotor skills and spatial skills. In this task, virtual paddles appear at the subject’s fingertips. The subject is instructed to use these paddles to hit and push away balls that are moving randomly towards the subject from one of 10 locations (i.e. bins). As the task proceeds the balls move at greater speeds and appear more often, making the task more difficult as time progresses.

Citation: Tyryshkin et al. 2014 documents the development of the task and its use for studying deficits in stroke. Most participants with stroke displayed asymmetric performance between their affected and non-affected limbs with regards to number of balls hit, workspace area covered by the limb and hand speed. Inter-rater reliability of task parameters was high and there were significant correlations were observed between many of the task parameters and the Functional Independence Measure and/or the Behavioural Inattention Test.

US Patent No. 8,740,794

The Ball on Bar task assesses bimanual coordination and visuomotor skills. During the task, a virtual bar is presented in between the subject’s hands and a virtual ball is placed on the bar. There are 4 target circles that are presented to the subject one at a time. The object of the task is to move the virtual ball on the bar into each presented target as quickly and accurately as possible. The task has three levels. On the first level the ball is fixed to the centre of the bar. On the second level the ball’s position on the bar is a function of the angle of the bar. On the third level the ball can move freely on the bar.

Citation: Lowrey et al. 2014 documents the development of the task. The study found that the task provides a quantitative measure of bimanual coordination and can sensitively identify impairments in a population of subjects with stroke.

The Arm Posture Perturbation task is meant to assess the subject’s ability to respond to unexpected disturbances to the arm when maintaining their hand at a target. During the task, the subject is shown a target to move to and once the subject moves a cursor representing their hand position into the target, a background load in one of 4 directions turns on slowly. After a random wait, the background load ramps off quickly. Good performance requires the ability to generate rapid corrective responses to these disturbances. *This task is only available with the Kinarm Exoskeleton Lab.

Citations: Bourke et al. 2015‘ s study found that subjects with stroke often have difficulties responding to the task’s mechanical disturbances, which may have important implications for performing daily abilities. Lowrey et al. 2019 concludes that the task provides an improved approach to assess rapid corrective responses of the arm in subjects with stroke where they found impairment is often equally felt in both arms.

During the Elbow Stretch task the robot attempts to rotate a subject’s elbow over a known angular range within a specified duration. It assesses the subject’s response to the passive stretch in order to quantify any increase in muscle tone or an uncontrollable increase in muscle activity due to joint position or motion. *This task is only available with the Kinarm Exoskeleton Lab.

Citation: Centen et al. 2017 concludes that the task can provide a sensitive and reliable assessment of post-stroke elbow spasticity while identifying characteristics of spasticity not attainable through coarse traditional scales.

The purpose of the Arm Position Matching task is to provide measures of a subject’s proprioceptive capabilities, specifically position sense in the upper limb. During the task the Kinarm robot will move one of the subject’s arms to a given position, and the subject is instructed to move their other arm to a mirror-matched position. Vision of the subject’s arms is blocked so that the subject can only use somatosensation from the arm to perceive arm position.

Citation: Dukelow et al. 2010 is the first publication indicating that Kinarm robots can provide a reliable quantitative means to assess deficits in limb position sense following stroke. It found that fifty percent of stroke subjects had some element of position sense impairment, indicating that this is a common problem.

U.S. Patent No. 8,277,396; CN Patent No. ZL200780047665.6; JP Patent No. 5368311; CA Patent No. 2,668,364

The Arm Movement Matching task, also known as the ‘Kines’ task, is meant to assess the ability of a subject to perceive limb motion or kinesthesia in a workspace, which is an another aspect of proprioception. During the task the Kinarm robot will move the subject’s arm via a controlled trajectory to a given position. The subject is then instructed to move their other arm to match the speed and direction of the movement. Vision of both arms are blocked so that the subject can only rely on somatosensation from the arm to perceive arm position.

Citations: Semrau et al. 2013’s study utilizes the task to identity kinesthetic deficits in subjects with stroke and found that the robotic approach allows for more sensitive, accurate, and objective identification. Semrau et al. 2017 concludes that the task exhibits good inter-rater reliability, which validates it as a reliable, objective method for quantifying kinesthesia after stroke.

To learn more about the task’s development and utility, hear more from its developers here.