Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis
Identifieur interne : 002A03 ( Main/Merge ); précédent : 002A02; suivant : 002A04Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis
Auteurs : Alma S. Merians [États-Unis] ; Gerard G. Fluet [États-Unis] ; Qinyin Qiu [États-Unis] ; Soha Saleh [États-Unis] ; Ian Lafond [États-Unis] ; Amy Davidow [États-Unis] ; Sergei V. Adamovich [États-Unis]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2011.
Abstract
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.
Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions.
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.
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.
Url:
DOI: 10.1186/1743-0003-8-27
PubMed: 21575185
PubMed Central: 3113321
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Fluet</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Qiu, Qinyin" sort="Qiu, Qinyin" uniqKey="Qiu Q" first="Qinyin" last="Qiu">Qinyin Qiu</name><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Saleh, Soha" sort="Saleh, Soha" uniqKey="Saleh S" first="Soha" last="Saleh">Soha Saleh</name><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Lafond, Ian" sort="Lafond, Ian" uniqKey="Lafond I" first="Ian" last="Lafond">Ian Lafond</name><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Davidow, Amy" sort="Davidow, Amy" uniqKey="Davidow A" first="Amy" last="Davidow">Amy Davidow</name><affiliation wicri:level="2"><nlm:aff id="I2">Department of Quantitative Methods, University of Medicine and Dentistry of New Jersey, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Quantitative Methods, University of Medicine and Dentistry of New Jersey, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Adamovich, Sergei V" sort="Adamovich, Sergei V" uniqKey="Adamovich S" first="Sergei V" last="Adamovich">Sergei V. 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Merians</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Fluet, Gerard G" sort="Fluet, Gerard G" uniqKey="Fluet G" first="Gerard G" last="Fluet">Gerard G. Fluet</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Qiu, Qinyin" sort="Qiu, Qinyin" uniqKey="Qiu Q" first="Qinyin" last="Qiu">Qinyin Qiu</name><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Saleh, Soha" sort="Saleh, Soha" uniqKey="Saleh S" first="Soha" last="Saleh">Soha Saleh</name><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Lafond, Ian" sort="Lafond, Ian" uniqKey="Lafond I" first="Ian" last="Lafond">Ian Lafond</name><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Davidow, Amy" sort="Davidow, Amy" uniqKey="Davidow A" first="Amy" last="Davidow">Amy Davidow</name><affiliation wicri:level="2"><nlm:aff id="I2">Department of Quantitative Methods, University of Medicine and Dentistry of New Jersey, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Quantitative Methods, University of Medicine and Dentistry of New Jersey, Newark</wicri:cityArea></affiliation></author><author><name sortKey="Adamovich, Sergei V" sort="Adamovich, Sergei V" uniqKey="Adamovich S" first="Sergei V" last="Adamovich">Sergei V. Adamovich</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="I3">Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">New Jersey</region></placeName><wicri:cityArea>Department of Biomedical Engineering, New Jersey Institute of Technology, Newark</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kwakkel, G" uniqKey="Kwakkel G">G Kwakkel</name></author><author><name sortKey="Kollen, Bj" uniqKey="Kollen B">BJ Kollen</name></author><author><name sortKey="Van Der Grond, J" uniqKey="Van Der Grond J">J van der Grond</name></author><author><name sortKey="Prevo, Aj" uniqKey="Prevo A">AJ Prevo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Carey, Jr" uniqKey="Carey J">JR Carey</name></author><author><name sortKey="Bhatt, E" uniqKey="Bhatt E">E Bhatt</name></author><author><name sortKey="Nagpal, A" uniqKey="Nagpal A">A Nagpal</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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Lum</name></author><author><name sortKey="Burgar, Cg" uniqKey="Burgar C">CG Burgar</name></author><author><name sortKey="Shor, Pc" uniqKey="Shor P">PC Shor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fasoli, Se" uniqKey="Fasoli S">SE Fasoli</name></author><author><name sortKey="Krebs, Hi" uniqKey="Krebs H">HI Krebs</name></author><author><name sortKey="Stein, J" uniqKey="Stein J">J Stein</name></author><author><name sortKey="Frontera, Wr" uniqKey="Frontera W">WR Frontera</name></author><author><name sortKey="Hogan, N" uniqKey="Hogan N">N Hogan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wulf, G" uniqKey="Wulf G">G Wulf</name></author><author><name sortKey="Mcnevin, Nh" uniqKey="Mcnevin N">NH McNevin</name></author><author><name sortKey="Fuchs, T" uniqKey="Fuchs T">T Fuchs</name></author><author><name sortKey="Ritter, F" uniqKey="Ritter F">F Ritter</name></author><author><name sortKey="Toole, T" uniqKey="Toole T">T Toole</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wulf, G" uniqKey="Wulf G">G Wulf</name></author><author><name sortKey="Landers, M" uniqKey="Landers M">M Landers</name></author><author><name sortKey="Lewthwaite, R" uniqKey="Lewthwaite R">R Lewthwaite</name></author><author><name sortKey="Tollner, T" uniqKey="Tollner T">T Tollner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Underwood, J" uniqKey="Underwood J">J Underwood</name></author><author><name sortKey="Clark, Pc" uniqKey="Clark P">PC Clark</name></author><author><name sortKey="Blanton, S" uniqKey="Blanton S">S Blanton</name></author><author><name sortKey="Aycock, Dm" uniqKey="Aycock D">DM Aycock</name></author><author><name sortKey="Wolf, Sl" uniqKey="Wolf S">SL Wolf</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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