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Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2011

Open Access 01-12-2011 | Research

Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis

Authors: Alma S Merians, Gerard G Fluet, Qinyin Qiu, Soha Saleh, Ian Lafond, Amy Davidow, Sergei V Adamovich

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2011

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Abstract

Background

Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training.

Methods

Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions.

Results

The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function.

Conclusions

Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training.
Appendix
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Metadata
Title
Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis
Authors
Alma S Merians
Gerard G Fluet
Qinyin Qiu
Soha Saleh
Ian Lafond
Amy Davidow
Sergei V Adamovich
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2011
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/1743-0003-8-27

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