Effects of a Robot-Assisted Arm Training Plus Hand Functional Electrical Stimulation on Recovery After Stroke: A Randomized Clinical Trial

Straudi, Sofía; Baroni, A.; Mele, Sonia; Craighero, Laila; Manfredini, Fabio; Lamberti, Nicola; Maietti, Elisa; Basaglia, Nino

doi:10.1016/j.apmr.2019.09.016

Cited by 36 publications

(40 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have shown that the mechanism of bilateral movement pattern was that the simultaneous movement of the same muscle groups on both sides was beneficial to the activation of similar neural networks in bilateral hemispheres, thereby reducing inter-hemispheric inhibition and improving the functional performance of paralytic hand (Renner et al, 2020). Several studies showed that bilateral training was superior to neurodevelopment treatment and unilateral robot-assisted training in improving upper limb motor function after stroke (Chen et al, 2019;Straudi et al, 2020). Finally, the linkage device of the robotic glove make it easy to realize the repeated movement of the affected hand, which can continuously provide positive feedback to the central nervous system through the peripheral movement and strengthen the neuronal circuit (Mane et al, 2020), thus facilitating the neural remodeling of the brain on the affected side.…”

Section: Introductionmentioning

confidence: 99%

Synergistic Immediate Cortical Activation on Mirror Visual Feedback Combined With a Soft Robotic Bilateral Hand Rehabilitation System: A Functional Near Infrared Spectroscopy Study

et al. 2022

View full text Add to dashboard Cite

BackgroundMirror visual feedback (MVF) has been widely used in neurological rehabilitation. Due to the potential gain effect of the MVF combination therapy, the related mechanisms still need be further analyzed.MethodsOur self-controlled study recruited 20 healthy subjects (age 22.150 ± 2.661 years) were asked to perform four different visual feedback tasks with simultaneous functional near infrared spectroscopy (fNIRS) monitoring. The right hand of the subjects was set as the active hand (performing active movement), and the left hand was set as the observation hand (static or performing passive movement under soft robotic bilateral hand rehabilitation system). The four VF tasks were designed as RVF Task (real visual feedback task), MVF task (mirror visual feedback task), BRM task (bilateral robotic movement task), and MVF + BRM task (Mirror visual feedback combined with bilateral robotic movement task).ResultsThe beta value of the right pre-motor cortex (PMC) of MVF task was significantly higher than the RVF task (RVF task: -0.015 ± 0.029, MVF task: 0.011 ± 0.033, P = 0.033). The beta value right primary sensorimotor cortex (SM1) in MVF + BRM task was significantly higher than MVF task (MVF task: 0.006 ± 0.040, MVF + BRM task: 0.037 ± 0.036, P = 0.016).ConclusionOur study used the synchronous fNIRS to compare the immediate hemodynamics cortical activation of four visual feedback tasks in healthy subjects. The results showed the synergistic gain effect on cortical activation from MVF combined with a soft robotic bilateral hand rehabilitation system for the first time, which could be used to guide the clinical application and the future studies.

show abstract

Section: Introductionmentioning

confidence: 99%

Synergistic Immediate Cortical Activation on Mirror Visual Feedback Combined With a Soft Robotic Bilateral Hand Rehabilitation System: A Functional Near Infrared Spectroscopy Study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Therefore, we framed the BCI intervention within a long-dose protocol containing treatment components targeting an array of impairments, and proven to have been efficacious upper limb motor function in past work [ 5 – 6 ]. Specifically, we interleaved clinically-based motor training sessions with the rt-fMRI and the rt-fNIRS; these clinically-based motor training sessions included exercise and standard-practice functional electrical stimulation (FES), both supported by research findings [ 6 , 29 , 30 ]. Thus, the secondary objective was to incorporate the sequential rt-fMRI, rt-fNIRS neural feedback system into a motor learning protocol.…”

Section: Introductionmentioning

confidence: 99%

Combined real-time fMRI and real time fNIRS brain computer interface (BCI): Training of volitional wrist extension after stroke, a case series pilot study

et al. 2021

View full text Add to dashboard Cite

Objective Pilot testing of real time functional magnetic resonance imaging (rt-fMRI) and real time functional near infrared spectroscopy (rt-fNIRS) as brain computer interface (BCI) neural feedback systems combined with motor learning for motor recovery in chronic severely impaired stroke survivors. Approach We enrolled a four-case series and administered three sequential rt-fMRI and ten rt-fNIRS neural feedback sessions interleaved with motor learning sessions. Measures were: Arm Motor Assessment Tool, functional domain (AMAT-F; 13 complex functional tasks), Fugl-Meyer arm coordination scale (FM); active wrist extension range of motion (ROM); volume of activation (fMRI); and fNIRS HbO concentration. Performance during neural feedback was assessed, in part, using percent successful brain modulations during rt-fNIRS. Main results Pre-/post-treatment mean clinically significant improvement in AMAT-F (.49 ± 0.22) and FM (10.0 ± 3.3); active wrist ROM improvement ranged from 20° to 50°. Baseline to follow-up change in brain signal was as follows: fMRI volume of activation was reduced in almost all ROIs for three subjects, and for one subject there was an increase or no change; fNIRS HbO was within normal range, except for one subject who increased beyond normal at post-treatment. During rt-fNIRS neural feedback training, there was successful brain signal modulation (42%–78%). Significance Severely impaired stroke survivors successfully engaged in spatially focused BCI systems, rt-fMRI and rt-fNIRS, to clinically significantly improve motor function. At the least, equivalency in motor recovery was demonstrated with prior long-duration motor learning studies (without neural feedback), indicating that no loss of motor improvement resulted from substituting neural feedback sessions for motor learning sessions. Given that the current neural feedback protocol did not prevent the motor improvements observed in other long duration studies, even in the presence of fewer sessions of motor learning in the current work, the results support further study of neural feedback and its potential for recovery of motor function in stroke survivors. In future work, expanding the sophistication of either or both rt-fMRI and rt-fNIRS could hold the potential for further reducing the number of hours of training needed and/or the degree of recovery. ClinicalTrials.gov ID: NCT02856035.

show abstract

“…Similar to BWSTT and robotic locomotor therapy, FES and arm/hand robots work to enable greater practice and have shown to be helpful in persons with CNS injuries. 5 , 25 , 62 Pilot testing using robotic glove therapies have been encouraging for improving hand function and pinch grip strength, 25 and in stroke patients there is considerable research being done on robotic assisted arm and hand therapy. 63 A recent randomized controlled trial reported that greater improvements were observed with high intensity hand therapy when controlled for stroke severity.…”

Section: Arm/hand Functionmentioning

confidence: 99%

“… 63 A recent randomized controlled trial reported that greater improvements were observed with high intensity hand therapy when controlled for stroke severity. 62 Thus research on comparative effectiveness of high intensity hand therapy and robotic and/or FES assisted arm/hand therapy should carefully control for degree of myelopathic severity.…”

Section: Arm/hand Functionmentioning

confidence: 99%

Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity?

Boerger

Hyngstrom

Furlan

et al. 2022

Global Spine Journal

View full text Add to dashboard Cite

Study Design Narrative review. Objective Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies. Methods Literature search. Results In other neurological disorders such as stroke and acute traumatic spinal cord injury (SCI), timely and strategic rehabilitation has been shown to be indispensable for maximizing functional outcomes, and it is imperative that appropriate perioperative rehabilitative interventions accompany surgical approaches in order to enable the best outcomes. In this review, the current state of knowledge regarding rehabilitation for PwCM is described. Additionally, various therapies that have shown to improve outcomes in comparable neurological conditions such as stroke and SCI which may be translated to DCM will be reviewed. Conclusions We conclude that locomotor training and arm/hand therapy may benefit PwCM. Further, we conclude that body weight support, robotic assistance, and virtual/augmented reality therapies may be beneficial therapeutic analogs to locomotor and hand therapies.

show abstract

Effects of a Robot-Assisted Arm Training Plus Hand Functional Electrical Stimulation on Recovery After Stroke: A Randomized Clinical Trial

Abstract: The effects of a robot-assisted arm training plus hand functional electrical stimulation on recovery after stroke: a randomized clinical trial,

Cited by 36 publications

References 38 publications

Synergistic Immediate Cortical Activation on Mirror Visual Feedback Combined With a Soft Robotic Bilateral Hand Rehabilitation System: A Functional Near Infrared Spectroscopy Study

Synergistic Immediate Cortical Activation on Mirror Visual Feedback Combined With a Soft Robotic Bilateral Hand Rehabilitation System: A Functional Near Infrared Spectroscopy Study

Combined real-time fMRI and real time fNIRS brain computer interface (BCI): Training of volitional wrist extension after stroke, a case series pilot study

Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity?

Contact Info

Product

Resources

About