Feasibility of the adaptive and automatic presentation of tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke
Identifieur interne : 002C26 ( Main/Merge ); précédent : 002C25; suivant : 002C27Feasibility of the adaptive and automatic presentation of tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke
Auteurs : Younggeun Choi [États-Unis, Corée du Sud] ; James Gordon [États-Unis] ; Hyeshin Park [États-Unis] ; Nicolas Schweighofer [États-Unis]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2011.
Abstract
Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task.
Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6) practiced four functional tasks (selected out of six in a pre-test) with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task.
No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT.
ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its efficacy will next be tested in a clinical trial.
Url:
DOI: 10.1186/1743-0003-8-42
PubMed: 21813010
PubMed Central: 3169456
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xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Computer Engineering, Dankook University, Yongin, Gyeonggi-do</wicri:regionArea><wicri:noRegion>Gyeonggi-do</wicri:noRegion></affiliation></author><author><name sortKey="Gordon, James" sort="Gordon, James" uniqKey="Gordon J" first="James" last="Gordon">James Gordon</name><affiliation wicri:level="4"><nlm:aff id="I1">Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName><orgName type="university">Université de Californie du Sud</orgName></affiliation></author><author><name sortKey="Park, Hyeshin" sort="Park, Hyeshin" uniqKey="Park H" first="Hyeshin" last="Park">Hyeshin Park</name><affiliation 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tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke</title><author><name sortKey="Choi, Younggeun" sort="Choi, Younggeun" uniqKey="Choi Y" first="Younggeun" last="Choi">Younggeun Choi</name><affiliation wicri:level="4"><nlm:aff id="I1">Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName><orgName type="university">Université de Californie du Sud</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Department of Computer Engineering, Dankook University, Yongin, Gyeonggi-do, South Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Computer Engineering, Dankook University, Yongin, Gyeonggi-do</wicri:regionArea><wicri:noRegion>Gyeonggi-do</wicri:noRegion></affiliation></author><author><name sortKey="Gordon, James" sort="Gordon, James" uniqKey="Gordon J" first="James" last="Gordon">James Gordon</name><affiliation wicri:level="4"><nlm:aff id="I1">Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName><orgName type="university">Université de Californie du Sud</orgName></affiliation></author><author><name sortKey="Park, Hyeshin" sort="Park, Hyeshin" uniqKey="Park H" first="Hyeshin" last="Park">Hyeshin Park</name><affiliation wicri:level="4"><nlm:aff id="I1">Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName><orgName type="university">Université de Californie du Sud</orgName></affiliation></author><author><name sortKey="Schweighofer, Nicolas" sort="Schweighofer, Nicolas" uniqKey="Schweighofer N" first="Nicolas" last="Schweighofer">Nicolas Schweighofer</name><affiliation wicri:level="4"><nlm:aff id="I1">Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName><orgName type="university">Université de Californie du Sud</orgName></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>Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task.</p></sec><sec><title>Methods</title><p>Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6) practiced four functional tasks (selected out of six in a pre-test) with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task.</p></sec><sec><title>Results</title><p>No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT.</p></sec><sec><title>Conclusions</title><p>ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. 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S">S Dorsch</name></author><author><name sortKey="Canning, C" uniqKey="Canning C">C Canning</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guadagnoli, Ma" uniqKey="Guadagnoli M">MA Guadagnoli</name></author><author><name sortKey="Lee, Td" uniqKey="Lee T">TD Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kwakkel, G" uniqKey="Kwakkel G">G Kwakkel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krakauer, Jw" uniqKey="Krakauer J">JW Krakauer</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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