Quantitative assessment of paretic limb dexterity and interlimb coordination during bilateral arm rehabilitation training

Abstract

In neuro-rehabilitation after stroke, the conventional constrained induced movement therapy (CIMT) has been well-accepted. Existing bilateral trainings are mostly on mirrored symmetrical motion. However, complementary bilateral movements are dominantly involved in activities of daily living (ADLs), and functional bilateral therapies may bring better skill transfer from trainings to daily life. Neurophysiological evidence is also growing. In this work, we firstly introduce our bilateral arm training system realized with a haptic interface and a motion sensor, as well as the tasks that have been designed to train both the manipulation function of the paretic arm and coordination of bilateral upper limbs. Then, we propose quantitative measures for functional assessment of complementary bilateral training performance, including kinematic behavior indices, smoothness, submovement and bimanual coordination. After that, we describe the experiments with healthy subjects and the results with respect to these quantitative measures. Feasibility and sensitivity of the proposed indices were evaluated through comparison of unilateral and bilateral training outcomes. The proposed bilateral training system and tasks, as well as the quantitative measures, have been demonstrated effective for training and assessment of unilateral and bilateral arm functions.

Short-term Efficacy of Hand-Arm Bimanual Intensive Training on Upper Arm Function in Acute Stroke Patients: A Randomized Controlled Trial

“…Nevertheless, we can still obtain a perspective based on other bilateral trainings and application of HABIT in other relevant populations ( 37 ), which have shown the capacity for intensive training to improve hand function after HABIT therapy, which is consistent with motor learning theories. Another bilateral arm training system including kinematic behavior, sub-movement and bimanual coordination, showed acceptable feasibility and sensitivity in terms of manipulation function of the paretic arm and coordination of the bilateral upper limbs ( 38 ). Besides, bilateral priming with active-passive movements promotes rebalancing of corticomotor excitability and would be expected to accelerate upper-limb recovery at the subacute stage as measured by ARAT ( 39 ).…”

Roles of Force Cues and Proprioceptive Joint Angles in Active Exploration of Compliant Objects

“…Ramp onset was defined at the first time when the derivative crossed 40% of peak value. Ramp ending was defined when the derivative passed 70% of the peak and dropped below 30% of the peak for the first time [19]. A least-squares linear regression was applied to this segmented trace and the stimulus-rate was set as the slope.…”

Asymmetric Bimanual ADL Training With Underactuated Exoskeleton Using Independent Joint Control and Visual Guidance

“…Asymmetric bimanual ADL training is often overlooked but necessary for stroke patients to regain ADL-related functions. The current robotic training focusing mainly on symmetric bilateral arm motion [3][4][5] is insufficient to train interlimb coordination because patients may have difficulties in in-phase, antiphase, and bilateral complementary motion [6,7]. So, training asymmetric bilateral arm motion is necessary, particularly for the complementary bilateral movement.…”