Multivariate outcomes in a three week bimanual self-telerehabilitation with error augmentation post-stroke

We present the outcomes of a study on stroke patients in a 3-week intervention of bimanual self-telerehabilitation. This training is similar to an upper-extremity treadmill in that patients can make use of their healthy arm to provide a cue for the more impaired arm. We further inspected a cohort that covertly received error augmentation training while they practiced. Finally, we focused here on the many quantitative measures available from the robotic device, testing if these measures collectively can predict outcome on the final day. We found in a cross-validation study that predictions are possible, yielding median r-squared values over 99%. Several particular measures were found to dominate their contribution to the prediction of recoverability. These results show that interactive self-rehabilitation may be a viable method for motor restoration, and the quantitative metrics available can be used to predict the eventual state of recovery.

[1]  Mitsuo Kawato,et al.  Feedback-Error-Learning Neural Network for Supervised Motor Learning , 1990 .

[2]  J. Cauraugh,et al.  Two Coupled Motor Recovery Protocols Are Better Than One: Electromyogram-Triggered Neuromuscular Stimulation and Bilateral Movements , 2002, Stroke.

[3]  S. Hesse,et al.  Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects. , 2003, Archives of physical medicine and rehabilitation.

[4]  J. Buurke,et al.  Effect of position feedback during task-oriented upper-limb training after stroke: five-case pilot study. , 2011, Journal of rehabilitation research and development.

[5]  T. Platz,et al.  Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study , 2005, Clinical rehabilitation.

[6]  James L Patton,et al.  Mirror versus parallel bimanual reaching , 2013, Journal of NeuroEngineering and Rehabilitation.

[7]  J. Patton,et al.  Evaluation of robotic training forces that either enhance or reduce error in chronic hemiparetic stroke survivors , 2005, Experimental Brain Research.

[8]  Hui Chen,et al.  Test-Retest Reproducibility and Smallest Real Difference of 5 Hand Function Tests in Patients With Stroke , 2009, Neurorehabilitation and neural repair.

[9]  D.J. Reinkensmeyer,et al.  Automating Arm Movement Training Following Severe Stroke: Functional Exercises With Quantitative Feedback in a Gravity-Reduced Environment , 2006, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[10]  J. H. van der Lee,et al.  Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial. , 1999, Stroke.

[11]  J. Whitall,et al.  Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke , 2000, Stroke.

[12]  C. Winstein,et al.  Bimanual Training After Stroke: Are Two Hands Better Than One? , 2004, Topics in stroke rehabilitation.

[13]  E. Taub,et al.  Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. , 1999, Journal of rehabilitation research and development.

[14]  Michael I. Jordan,et al.  Constrained and unconstrained movements involve different control strategies. , 1997, Journal of neurophysiology.

[15]  S. Wolf,et al.  Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke , 2001, Stroke.

[16]  Terry E. Duncan,et al.  Psychometric properties of the Intrinsic Motivation Inventory in a competitive sport setting: a confirmatory factor analysis. , 1989, Research quarterly for exercise and sport.

[17]  N. Hogan,et al.  Comparison of Two Techniques of Robot-Aided Upper Limb Exercise Training After Stroke , 2004, American journal of physical medicine & rehabilitation.

[18]  P A Thompson,et al.  The Motor Activity Log-28 , 2006, Neurology.

[19]  T. Rahman,et al.  A body-powered functional upper limb orthosis. , 2000, Journal of rehabilitation research and development.

[20]  P. Gribble,et al.  Are there distinct neural representations of object and limb dynamics? , 2006, Experimental Brain Research.

[21]  R. Shepherd,et al.  Task-related training improves performance of seated reaching tasks after stroke. A randomized controlled trial. , 1997, Stroke.

[22]  E. Vaadia,et al.  Primary motor cortex is involved in bimanual coordination , 1998, Nature.

[23]  N. Sadato,et al.  Role of the Supplementary Motor Area and the Right Premotor Cortex in the Coordination of Bimanual Finger Movements , 1997, The Journal of Neuroscience.

[24]  Jill Whitall,et al.  Fine motor control in adults with and without chronic hemiparesis: baseline comparison to nondisabled adults and effects of bilateral arm training. , 2004, Archives of physical medicine and rehabilitation.

[25]  Chris Scharver,et al.  Robotics and Virtual Reality: A Perfect Marriage for Motor Control Research and Rehabilitation , 2006, Assistive technology : the official journal of RESNA.

[26]  Donald Hedeker,et al.  Error Augmentation Enhancing Arm Recovery in Individuals With Chronic Stroke , 2014, Neurorehabilitation and neural repair.

[27]  Neville Hogan,et al.  Intensive Sensorimotor Arm Training Mediated by Therapist or Robot Improves Hemiparesis in Patients With Chronic Stroke , 2008, Neurorehabilitation and neural repair.

[28]  C. Burgar,et al.  Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. , 2002, Archives of physical medicine and rehabilitation.

[29]  B. Volpe,et al.  Motor Impairment as a Predictor of Functional Recovery and Guide to Rehabilitation Treatment After Stroke , 2001, Neurorehabilitation and neural repair.

[30]  N. Hogan,et al.  Robotics and other devices in the treatment of patients recovering from stroke , 2004, Current neurology and neuroscience reports.

[31]  Ferdinando A. Mussa-Ivaldi,et al.  Robot-assisted adaptive training: custom force fields for teaching movement patterns , 2004, IEEE Transactions on Biomedical Engineering.

[32]  D. Reisman,et al.  Observation of amounts of movement practice provided during stroke rehabilitation. , 2009, Archives of physical medicine and rehabilitation.

[33]  Paul A Thompson,et al.  Retention of upper limb function in stroke survivors who have received constraint-induced movement therapy: the EXCITE randomised trial , 2008, The Lancet Neurology.

[34]  C. Patten,et al.  Reproducibility and Minimal Detectable Change of Three-Dimensional Kinematic Analysis of Reaching Tasks in People With Hemiparesis After Stroke , 2008, Physical Therapy.

[35]  Qiang Wang,et al.  a randomized controlled trial Effects of intensity of arm training on hemiplegic upper extremity motor recovery in stroke , 2012 .

[36]  N. Hogan,et al.  Robotics and other devices in the treatment of patients recovering from stroke , 2005, Current atherosclerosis reports.

[37]  Stacy L Fritz,et al.  Minimal Detectable Change Scores for the Wolf Motor Function Test , 2009, Neurorehabilitation and neural repair.

[38]  T. Matyas,et al.  Can simultaneous bilateral movement involve the undamaged hemisphere in reconstruction of neural networks damaged by stroke? , 2000, Disability and rehabilitation.

[39]  J. Whitall,et al.  Bilateral arm training: why and who benefits? , 2008, NeuroRehabilitation.