The Effect of an Upper Limb Rehabilitation Robot on Hemispatial Neglect in Stroke Patients

Choi, Younghoon; Lee, Kyeong Woo; Lee, Jong Hwa; Kim, Sang Beom; Park, Gyu Tae; Lee, Sook Jeong

doi:10.5535/arm.2016.40.4.611

Cited by 15 publications

(32 citation statements)

References 32 publications

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“…Our data show that key features of prism adaptation, such as limb displacement from the body or visual field midline, and a mismatch between vision and proprioception, are not necessary to influence EEG responses that reflect orienting and disengagement of spatial attention in healthy young adults. In future research, it will be important to see whether force field learning can improve clinical symptoms in patients with neglect and other attention disorders, and if so, whether the effect size is comparable to that induced by prism adaptation or other movement‐based therapies, such as moving in contralesional space or robot‐assisted training (Choi et al., ; Varalta et al., ). Testing the effects of force field adaptation on spatial attention in patients might also shed light on the mechanisms by which prism adaptation improves symptoms of neglect, and may ultimately lead to new forms of therapy based on physical rather than visual perturbations.…”

Section: Discussionmentioning

confidence: 99%

Pushing attention to one side: Force field adaptation alters neural correlates of orienting and disengagement of spatial attention

Reuter

Mattingley

Cunnington

et al. 2018

Eur J of Neuroscience

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Sensorimotor adaptation to wedge prisms can alter the balance of attention between left and right space in healthy adults, and improve symptoms of spatial neglect after stroke. Here we asked whether the orienting of spatial attention to visual stimuli is affected by a different form of sensorimotor adaptation that involves physical perturbations of arm movement, rather than distortion of visual feedback. Healthy participants performed a cued discrimination task before and after they made reaching movements to a central target. A velocity‐dependent force field pushed the hand aside during each reach, and required participants to apply compensatory forces toward the opposite side. We used event‐related potentials (ERPs) to determine whether electroencephalography (EEG) responses reflecting orienting (cue‐locked N1) and disengagement (target‐locked P1) of spatial attention are affected by adaptation to force fields. After adaptation, the cue‐locked N1 was relatively larger for stimuli presented in the hemispace corresponding to the direction of compensatory hand force. P1 amplitudes evoked by invalidly cued targets presented on the opposite side were reduced. This suggests that force field adaptation boosted attentional orienting responses toward the side of hand forces, and impeded attentional disengagement from that side, mimicking previously reported effects of prism adaptation. Thus, remapping between motor commands and intended movement direction is sufficient to bias ERPs, reflecting changes in the orienting of spatial attention in the absence of visuo‐spatial distortion or visuo‐proprioceptive mismatch. Findings are relevant to theories of how sensorimotor adaptation can modulate attention, and may open new avenues for treatment of spatial neglect.

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Section: Discussionmentioning

confidence: 99%

Pushing attention to one side: Force field adaptation alters neural correlates of orienting and disengagement of spatial attention

Reuter

Mattingley

Cunnington

et al. 2018

Eur J of Neuroscience

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show abstract

“…In addition, new therapies for neglect treatment have been applied through several recent studies. Among these new therapies, treatment using noninvasive brain stimulation and treatment assisted with computer programs and robots have been reported to be effective in rehabilitation of hemispatial neglect [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have also demonstrated that robot-assisted hemispatial neglect therapy is effective for the recovery of hemispatial neglect [16]. By modifying the existing robot therapy in another study, patient was placed on the right side of the robot monitor [17]. The patient obtained visual scanning effect in addition to the effect of robot therapy [17].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Combined Therapy of Robot and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Hemispatial Neglect in Stroke Patients

Kim

Lee

et al. 2018

Ann Rehabil Med

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ObjectiveTo investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients.MethodsPatients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment.ResultsFor each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups.ConclusionTreatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Resultsof this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.

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“…The patient in this study showed improvements in proprioception (measured by TFT) and hemispatial neglect after robotic mirror therapy. Conventional mirror therapy is also known to be effective for hemispatial neglect ( 8 25 26 27 28 ), and recently upper limb rehabilitation robot was shown to have beneficial effects on hemispatial neglect ( 29 30 ). In the fMRI analysis after all treatment sessions, the lower part of the superior parietal lobule and PMC were co-activated during the passive ROM exercise.…”

Section: Discussionmentioning

confidence: 99%

Recovery of Proprioception in the Upper Extremity by Robotic Mirror Therapy: a Clinical Pilot Study for Proof of Concept

et al. 2017

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A novel robotic mirror therapy system was recently developed to provide proprioceptive stimulus to the hemiplegic arm during a mirror therapy. Validation of the robotic mirror therapy system was performed to confirm its synchronicity prior to the clinical study. The mean error angle range between the intact arm and the robot was 1.97 to 4.59 degrees. A 56-year-old male who had right middle cerebral artery infarction 11 months ago received the robotic mirror therapy for ten 30-minute sessions during 2 weeks. Clinical evaluation and functional magnetic resonance imaging (fMRI) studies were performed before and after the intervention. At the follow-up evaluation, the thumb finding test score improved from 2 to 1 for eye level and from 3 to 1 for overhead level. The Albert's test score on the left side improved from 6 to 11. Improvements were sustained at 2-month follow-up. The fMRI during the passive motion revealed a considerable increase in brain activity at the lower part of the right superior parietal lobule, suggesting the possibility of proprioception enhancement. The robotic mirror therapy system may serve as a useful treatment method for patients with supratentorial stroke to facilitate recovery of proprioceptive deficit and hemineglect.

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The Effect of an Upper Limb Rehabilitation Robot on Hemispatial Neglect in Stroke Patients

Cited by 15 publications

References 32 publications

Pushing attention to one side: Force field adaptation alters neural correlates of orienting and disengagement of spatial attention

Pushing attention to one side: Force field adaptation alters neural correlates of orienting and disengagement of spatial attention

Effect of Combined Therapy of Robot and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Hemispatial Neglect in Stroke Patients

Recovery of Proprioception in the Upper Extremity by Robotic Mirror Therapy: a Clinical Pilot Study for Proof of Concept

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