Effects of a Robot-aided Somatosensory Training on Proprioception and Motor Function in Stroke Survivors
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| Názov: | Effects of a Robot-aided Somatosensory Training on Proprioception and Motor Function in Stroke Survivors |
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| Autori: | I-Ling Yeh, Jessica Holst-Wolf, Naveen Elangovan, Anna Vera Cuppone, Kamakshi Lakshminarayan, Leonardo Cappello, Lorenzo Masia, Jürgen Konczak |
| Zdroj: | J Neuroeng Rehabil Journal of NeuroEngineering and Rehabilitation, Vol 18, Iss 1, Pp 1-11 (2021) |
| Informácie o vydavateľovi: | Springer Science and Business Media LLC, 2020. |
| Rok vydania: | 2020 |
| Predmety: | Adult, Male, Wrist Joint, Neurosciences. Biological psychiatry. Neuropsychiatry, Proof of Concept Study, 03 medical and health sciences, 0302 clinical medicine, Cerebrovascular disease/stroke, Survivors [MeSH], Aged [MeSH], Proprioception/physiology [MeSH], Stroke/complications [MeSH], Sensation Disorders/etiology [MeSH], Wrist Joint/physiopathology [MeSH], Exoskeleton Device [MeSH], Male [MeSH], Stroke Rehabilitation/instrumentation [MeSH], Stroke Rehabilitation/methods [MeSH], Upper limb, Assistive Technology and Brain Machine Interface, Female [MeSH], Adult [MeSH], Humans [MeSH], Somatosensation, Robotics [MeSH], Middle Aged [MeSH], Human, Sensation Disorders/rehabilitation [MeSH], Rehabilitation, Research, Stroke/physiopathology [MeSH], Proof of Concept Study [MeSH], Psychomotor Performance/physiology [MeSH], Humans, Survivors, Aged, Stroke Rehabilitation, Robotics, Middle Aged, Exoskeleton Device, Proprioception, 16. Peace & justice, 3. Good health, Stroke, Sensation Disorders, Female, Psychomotor Performance, RC321-571 |
| Popis: | Background- Proprioceptive deficits after stroke are associated with poor upper limb function, slower motor recovery, and decreased self-care ability. Improving proprioception should enhance motor control in stroke survivors, but current evidence is inconclusive. Thus, this study examined whether a robot-aided somatosensory-based training requiring increasingly accurate active wrist movements improves proprioceptive acuity and motor performance in chronic stroke. Methods - Twelve adults with chronic stroke completed a 2-day training (age range: 42 – 74 years; median time-after-stroke: 12 months; median Fugl-Meyer UE: 65). Retention was assessed at Day 5. Grasping the handle of a wrist-robotic exoskeleton, participants trained to roll a virtual ball to a target through continuous wrist adduction/abduction movements. During training vision was occluded, but participants received real-time, vibro-tactile feedback on their forearm about ball position and speed. Primary outcome was the just-noticeable-difference (JND) wrist position sense threshold as a measure of proprioceptive acuity. Secondary outcomes were spatial error in an untrained wrist tracing task and somatosensory-evoked potentials (SEP) as a neural correlate of proprioceptive function. Ten neurologically-intact adults were recruited to serve as non-stroke controls for age, gender and hand dominance (age range: 44 to 79 years; 6 women, 4 men).Results – Participants significantly reduced JND thresholds at posttest and retention (F(2, 38) = 4.54, p = 0.017, ηp2 = 0.20) in both groups. A higher pretest JND threshold was associated with a higher threshold reduction at posttest and retention (r = -0.86, -0.90, p ≤ 0.001) among the stroke participants. Error in the untrained tracing task was reduced by 22% at posttest, yielding an effect size of w = 0.13. Stroke participants exhibited significantly reduced P27-N30 peak-to-peak SEP amplitude at pretest (U = 11, p = 0.03) compared to the non-stroke group. SEP measures did not change systematically with training.Conclusion - This study provides proof-of-concept that non-visual, proprioceptive training can induce fast, measurable improvements in proprioceptive function in chronic stroke survivors. There is encouraging but inconclusive evidence that such somatosensory learning transfers to untrained motor tasks.Trial Registration Clinicaltrials.gov; Registration ID: NCT02565407; Date of registration: 01/10/2015; URL: https://clinicaltrials.gov/ct2/show/NCT02565407 |
| Druh dokumentu: | Article Other literature type |
| Popis súboru: | application/pdf |
| ISSN: | 1743-0003 |
| DOI: | 10.21203/rs.3.rs-89369/v1 |
| DOI: | 10.1186/s12984-021-00871-x |
| Prístupová URL adresa: | https://www.researchsquare.com/article/rs-89369/v1.pdf https://jneuroengrehab.biomedcentral.com/track/pdf/10.1186/s12984-021-00871-x https://pubmed.ncbi.nlm.nih.gov/33971912 https://doaj.org/article/ed284ec56ebe4ba78fe2d67236a8cd51 https://europepmc.org/article/PMC/PMC8112068 http://www.ncbi.nlm.nih.gov/pubmed/33971912 https://link.springer.com/article/10.1186/s12984-021-00871-x https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-021-00871-x https://link.springer.com/content/pdf/10.1186/s12984-021-00871-x.pdf https://www.researchsquare.com/article/rs-89369/v1 https://repository.publisso.de/resource/frl:6465820 |
| Rights: | CC BY CC BY NC SA |
| Prístupové číslo: | edsair.doi.dedup.....d7020b919b8366d968a504bc57458f91 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Background- Proprioceptive deficits after stroke are associated with poor upper limb function, slower motor recovery, and decreased self-care ability. Improving proprioception should enhance motor control in stroke survivors, but current evidence is inconclusive. Thus, this study examined whether a robot-aided somatosensory-based training requiring increasingly accurate active wrist movements improves proprioceptive acuity and motor performance in chronic stroke. Methods - Twelve adults with chronic stroke completed a 2-day training (age range: 42 – 74 years; median time-after-stroke: 12 months; median Fugl-Meyer UE: 65). Retention was assessed at Day 5. Grasping the handle of a wrist-robotic exoskeleton, participants trained to roll a virtual ball to a target through continuous wrist adduction/abduction movements. During training vision was occluded, but participants received real-time, vibro-tactile feedback on their forearm about ball position and speed. Primary outcome was the just-noticeable-difference (JND) wrist position sense threshold as a measure of proprioceptive acuity. Secondary outcomes were spatial error in an untrained wrist tracing task and somatosensory-evoked potentials (SEP) as a neural correlate of proprioceptive function. Ten neurologically-intact adults were recruited to serve as non-stroke controls for age, gender and hand dominance (age range: 44 to 79 years; 6 women, 4 men).Results – Participants significantly reduced JND thresholds at posttest and retention (F(2, 38) = 4.54, p = 0.017, ηp2 = 0.20) in both groups. A higher pretest JND threshold was associated with a higher threshold reduction at posttest and retention (r = -0.86, -0.90, p ≤ 0.001) among the stroke participants. Error in the untrained tracing task was reduced by 22% at posttest, yielding an effect size of w = 0.13. Stroke participants exhibited significantly reduced P27-N30 peak-to-peak SEP amplitude at pretest (U = 11, p = 0.03) compared to the non-stroke group. SEP measures did not change systematically with training.Conclusion - This study provides proof-of-concept that non-visual, proprioceptive training can induce fast, measurable improvements in proprioceptive function in chronic stroke survivors. There is encouraging but inconclusive evidence that such somatosensory learning transfers to untrained motor tasks.Trial Registration Clinicaltrials.gov; Registration ID: NCT02565407; Date of registration: 01/10/2015; URL: https://clinicaltrials.gov/ct2/show/NCT02565407 |
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| ISSN: | 17430003 |
| DOI: | 10.21203/rs.3.rs-89369/v1 |