NDLI: Effects of a robot‐aided somatosensory training on proprioception and motor function in stroke survivors

Content Provider	Springer Nature : BioMed Central
Author	Yeh, I-Ling Holst-Wolf, Jessica Elangovan, Naveen Cuppone, Anna Vera Lakshminarayan, Kamakshi Cappello, Leonardo Masia, Lorenzo Konczak, Jürgen
Abstract	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 as well as 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 matched 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 (Stroke group: pretest: mean: 1.77° [SD: 0.54°] to posttest mean: 1.38° [0.34°]; Control group: 1.50° [0.46°] to posttest mean: 1.45° [SD: 0.54°]; F[2,37] = 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. Conclusions 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 .
Related Links	https://jneuroengrehab.biomedcentral.com/counter/pdf/10.1186/s12984-021-00871-x.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	17430003
DOI	10.1186/s12984-021-00871-x
Journal	Journal of NeuroEngineering and Rehabilitation
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2021-05-10
Access Restriction	Open
Subject Keyword	Neurosciences Neurology Rehabilitation Medicine Biomedical Engineering and Bioengineering Human Somatosensation Upper limb Rehabilitation Cerebrovascular disease/stroke
Content Type	Text
Resource Type	Article
Subject	Health Informatics Rehabilitation
Journal Impact Factor	5.2/2023
5-Year Journal Impact Factor	5.6/2023

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Correction to: Effects of a robot‐aided somatosensory training on proprioception and motor function in stroke survivors

Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke

Effects of upper limb robot-assisted therapy on motor recovery in subacute stroke patients

The independence of impairments in proprioception and visuomotor adaptation after stroke

A robot-aided visuomotor wrist training induces motor and proprioceptive learning that transfers to the untrained ipsilateral elbow

Reliable and valid robot-assisted assessments of hand proprioceptive, motor and sensorimotor impairments after stroke

Robot-based assessment of motor and proprioceptive function identifies biomarkers for prediction of functional independence measures

Mapping upper-limb motor performance after stroke - a novel method with utility for individualized motor training

Effects of brain-computer interface based training on post-stroke upper-limb rehabilitation: a meta-analysis

Effects of a robot‐aided somatosensory training on proprioception and motor function in stroke survivors

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Correction to: Effects of a robot‐aided somatosensory training on proprioception and motor function in stroke survivors

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The independence of impairments in proprioception and visuomotor adaptation after stroke

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Effects of a robot‐aided somatosensory training on proprioception and motor function in stroke survivors