Effects of an upper limb robot-mediated therapy on paretic upper limb in chronic hemiparetic subjects: A biomechanical and EEG-based approach for functional assessment

Mazzoleni, Stefano; Coscia, Martina; Aliboni, S.; Posteraro, Federico; Carrozza, Maria Chiara

doi:10.1109/icorr.2009.5209579

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…To our knowledge, this is the first study that explores the effects of passive bilateral upper limb robot-aided rehabilitation by behavioral and EEG assessments in chronic stroke patients. So far, few studies have reported on the modulation of EEG cortical activity during robot-assisted tasks [ 17 , 18 , 29 , 70 , 71 ] and none have evaluated the effects of passive R-BAT on spasticity. The major advances in this study compared to our previous research is the investigation of neural correlates of behavioral changes after robot-assisted training in chronic stroke patients.…”

Section: Discussionmentioning

confidence: 99%

Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

et al. 2018

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Background Bilateral arm training (BAT) has shown promise in expediting progress toward upper limb recovery in chronic stroke patients, but its neural correlates are poorly understood. Objective To evaluate changes in upper limb function and EEG power after a robot-assisted BAT in chronic stroke patients. Methods In a within-subject design, seven right-handed chronic stroke patients with upper limb paresis received 21 sessions (3 days/week) of the robot-assisted BAT. The outcomes were changes in score on the upper limb section of the Fugl-Meyer assessment (FM), Motricity Index (MI), and Modified Ashworth Scale (MAS) evaluated at the baseline (T0), posttraining (T1), and 1-month follow-up (T2). Event-related desynchronization/synchronization were calculated in the upper alpha and the beta frequency ranges. Results Significant improvement in all outcomes was measured over the course of the study. Changes in FM were significant at T2, and in MAS at T1 and T2. After training, desynchronization on the ipsilesional sensorimotor areas increased during passive and active movement, as compared with T0. Conclusions A repetitive robotic-assisted BAT program may improve upper limb motor function and reduce spasticity in the chronically impaired paretic arm. Effects on spasticity were associated with EEG changes over the ipsilesional sensorimotor network.

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Section: Discussionmentioning

confidence: 99%

Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

et al. 2018

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“…Electroencephalogram (EEG) features have been shown to correlate with functional recovery after stroke, both across subjects [23–26] and in longitudinal studies [10, 27–31]. However, the signal features traditionally utilized for such purposes are not sufficiently specific, and the search for more suitable features continues [13].…”

Section: Introductionmentioning

confidence: 99%

Topographical measures of functional connectivity as biomarkers for post-stroke motor recovery

Philips

Daly

Prı́ncipe

2017

J NeuroEngineering Rehabil

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BackgroundBiomarkers derived from neural activity of the brain present a vital tool for the prediction and evaluation of post-stroke motor recovery, as well as for real-time biofeedback opportunities.MethodsIn order to encapsulate recovery-related reorganization of brain networks into such biomarkers, we have utilized the generalized measure of association (GMA) and graph analyses, which include global and local efficiency, as well as hemispheric interdensity and intradensity. These methods were applied to electroencephalogram (EEG) data recorded during a study of 30 stroke survivors (21 male, mean age 57.9 years, mean stroke duration 22.4 months) undergoing 12 weeks of intensive therapeutic intervention.ResultsWe observed that decreases of the intradensity of the unaffected hemisphere are correlated (r s=−0.46;p<0.05) with functional recovery, as measured by the upper-extremity portion of the Fugl-Meyer Assessment (FMUE). In addition, high initial values of local efficiency predict greater improvement in FMUE (R 2=0.16;p<0.05). In a subset of 17 subjects possessing lesions of the cerebral cortex, reductions of global and local efficiency, as well as the intradensity of the unaffected hemisphere are found to be associated with functional improvement (r s=−0.60,−0.66,−0.75;p<0.05). Within the same subgroup, high initial values of global and local efficiency, are predictive of improved recovery (R 2=0.24,0.25;p<0.05). All significant findings were specific to the 12.5–25 Hz band.ConclusionsThese topological measures show promise for prognosis and evaluation of therapeutic outcomes, as well as potential application to BCI-enabled biofeedback.

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“…To date, only two studies have reported cortical activity during robot-assisted tasks [26,27]. Using NIRS, Saeki et al [27] investigated whether robotic training of the affected arm in a chronic stroke patient would lead to an increase in cortical activity in addition to evident motor recovery.…”

Section: Introductionmentioning

confidence: 99%

“…During the active-passive mode training, asymmetrical activation was observed in the sensorimotor cortex, premotor cortex and supplementary motor area (SMA), but no regional activity was noted during bimanual passive movement. Mazzoleni et al [26] evaluated the effects of robot-mediated therapy with the MIT-Manus on the upper limb in chronic hemiparetic subjects. They developed an integrated analysis of quantitative parameters computed from EEG signals, kinematic and dynamic data, and clinical assessment scales.…”

Section: Introductionmentioning

confidence: 99%

Modulation of event-related desynchronization in robot-assisted hand performance: brain oscillatory changes in active, passive and imagined movements

Formaggio

Storti

Galazzo

et al. 2013

J NeuroEngineering Rehabil

102

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BackgroundRobot-assisted therapy in patients with neurological disease is an attempt to improve function in a moderate to severe hemiparetic arm. A better understanding of cortical modifications after robot-assisted training could aid in refining rehabilitation therapy protocols for stroke patients. Modifications of cortical activity in healthy subjects were evaluated during voluntary active movement, passive robot-assisted motor movement, and motor imagery tasks performed under unimanual and bimanual protocols.MethodsTwenty-one channel electroencephalography (EEG) was recorded with a video EEG system in 8 subjects. The subjects performed robot-assisted tasks using the Bi-Manu Track robot-assisted arm trainer. The motor paradigm was executed during one-day experimental sessions under eleven unimanual and bimanual protocols of active, passive and imaged movements. The event-related-synchronization/desynchronization (ERS/ERD) approach to the EEG data was applied to investigate where movement-related decreases in alpha and beta power were localized.ResultsVoluntary active unilateral hand movement was observed to significantly activate the contralateral side; however, bilateral activation was noted in all subjects on both the unilateral and bilateral active tasks, as well as desynchronization of alpha and beta brain oscillations during the passive robot-assisted motor tasks. During active-passive movement when the right hand drove the left one, there was predominant activation in the contralateral side. Conversely, when the left hand drove the right one, activation was bilateral, especially in the alpha range. Finally, significant contralateral EEG desynchronization was observed during the unilateral task and bilateral ERD during the bimanual task.ConclusionsThis study suggests new perspectives for the assessment of patients with neurological disease. The findings may be relevant for defining a baseline for future studies investigating the neural correlates of behavioral changes after robot-assisted training in stroke patients.

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Effects of an upper limb robot-mediated therapy on paretic upper limb in chronic hemiparetic subjects: A biomechanical and EEG-based approach for functional assessment

Cited by 11 publications

References 12 publications

Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

Topographical measures of functional connectivity as biomarkers for post-stroke motor recovery

Modulation of event-related desynchronization in robot-assisted hand performance: brain oscillatory changes in active, passive and imagined movements

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