Effect of visual distraction and auditory feedback on patient effort during robot-assisted movement training after stroke
Identifieur interne : 002C47 ( Main/Merge ); précédent : 002C46; suivant : 002C48Effect of visual distraction and auditory feedback on patient effort during robot-assisted movement training after stroke
Auteurs : Riccardo Secoli [États-Unis] ; Marie-Helene Milot [États-Unis] ; Giulio Rosati [Italie] ; David J. Reinkensmeyer [États-Unis]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2011.
Abstract
Practicing arm and gait movements with robotic assistance after neurologic injury can help patients improve their movement ability, but patients sometimes reduce their effort during training in response to the assistance. Reduced effort has been hypothesized to diminish clinical outcomes of robotic training. To better understand patient slacking, we studied the role of visual distraction and auditory feedback in modulating patient effort during a common robot-assisted tracking task.
Fourteen participants with chronic left hemiparesis from stroke, five control participants with chronic right hemiparesis and fourteen non-impaired healthy control participants, tracked a visual target with their arms while receiving adaptive assistance from a robotic arm exoskeleton. We compared four practice conditions: the baseline tracking task alone; tracking while also performing a visual distracter task; tracking with the visual distracter and sound feedback; and tracking with sound feedback. For the distracter task, symbols were randomly displayed in the corners of the computer screen, and the participants were instructed to click a mouse button when a target symbol appeared. The sound feedback consisted of a repeating beep, with the frequency of repetition made to increase with increasing tracking error.
Participants with stroke halved their effort and doubled their tracking error when performing the visual distracter task with their left hemiparetic arm. With sound feedback, however, these participants increased their effort and decreased their tracking error close to their baseline levels, while also performing the distracter task successfully. These effects were significantly smaller for the participants who used their non-paretic arm and for the participants without stroke.
Visual distraction decreased participants effort during a standard robot-assisted movement training task. This effect was greater for the hemiparetic arm, suggesting that the increased demands associated with controlling an affected arm make the motor system more prone to slack when distracted. Providing an alternate sensory channel for feedback, i.e., auditory feedback of tracking error, enabled the participants to simultaneously perform the tracking task and distracter task effectively. Thus, incorporating real-time auditory feedback of performance errors might improve clinical outcomes of robotic therapy systems.
Url:
DOI: 10.1186/1743-0003-8-21
PubMed: 21513561
PubMed Central: 3104373
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effect of visual distraction and auditory feedback on patient effort during robot-assisted movement training after stroke</title><author><name sortKey="Secoli, Riccardo" sort="Secoli, Riccardo" uniqKey="Secoli R" first="Riccardo" last="Secoli">Riccardo Secoli</name><affiliation wicri:level="2"><nlm:aff id="I2">Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Milot, Marie Helene" sort="Milot, Marie Helene" uniqKey="Milot M" first="Marie-Helene" last="Milot">Marie-Helene Milot</name><affiliation wicri:level="2"><nlm:aff id="I2">Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Rosati, Giulio" sort="Rosati, Giulio" uniqKey="Rosati G" first="Giulio" last="Rosati">Giulio Rosati</name><affiliation wicri:level="1"><nlm:aff id="I1">Robotics Lab, Department of Innovation in Mechanics and Management, University of Padua, Via Venezia 1, 35131 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Robotics Lab, Department of Innovation in Mechanics and Management, University of Padua, Via Venezia 1, 35131 Padova</wicri:regionArea><wicri:noRegion>35131 Padova</wicri:noRegion></affiliation></author><author><name sortKey="Reinkensmeyer, David J" sort="Reinkensmeyer, David J" uniqKey="Reinkensmeyer D" first="David J" last="Reinkensmeyer">David J. Reinkensmeyer</name><affiliation wicri:level="2"><nlm:aff id="I3">Departments of Mechanical and Aerospace Engineering, Anatomy and Neurobiology, and Biomedical Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Mechanical and Aerospace Engineering, Anatomy and Neurobiology, and Biomedical Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21513561</idno><idno type="pmc">3104373</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104373</idno><idno type="RBID">PMC:3104373</idno><idno type="doi">10.1186/1743-0003-8-21</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002044</idno><idno type="wicri:Area/Pmc/Curation">002044</idno><idno type="wicri:Area/Pmc/Checkpoint">001B64</idno><idno type="wicri:Area/Ncbi/Merge">001A06</idno><idno type="wicri:Area/Ncbi/Curation">001A06</idno><idno type="wicri:Area/Ncbi/Checkpoint">001A06</idno><idno type="wicri:Area/Main/Merge">002C47</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effect of visual distraction and auditory feedback on patient effort during robot-assisted movement training after stroke</title><author><name sortKey="Secoli, Riccardo" sort="Secoli, Riccardo" uniqKey="Secoli R" first="Riccardo" last="Secoli">Riccardo Secoli</name><affiliation wicri:level="2"><nlm:aff id="I2">Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Milot, Marie Helene" sort="Milot, Marie Helene" uniqKey="Milot M" first="Marie-Helene" last="Milot">Marie-Helene Milot</name><affiliation wicri:level="2"><nlm:aff id="I2">Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Biomechatronic Lab., Departments of Mechanical and Aerospace Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Rosati, Giulio" sort="Rosati, Giulio" uniqKey="Rosati G" first="Giulio" last="Rosati">Giulio Rosati</name><affiliation wicri:level="1"><nlm:aff id="I1">Robotics Lab, Department of Innovation in Mechanics and Management, University of Padua, Via Venezia 1, 35131 Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Robotics Lab, Department of Innovation in Mechanics and Management, University of Padua, Via Venezia 1, 35131 Padova</wicri:regionArea><wicri:noRegion>35131 Padova</wicri:noRegion></affiliation></author><author><name sortKey="Reinkensmeyer, David J" sort="Reinkensmeyer, David J" uniqKey="Reinkensmeyer D" first="David J" last="Reinkensmeyer">David J. Reinkensmeyer</name><affiliation wicri:level="2"><nlm:aff id="I3">Departments of Mechanical and Aerospace Engineering, Anatomy and Neurobiology, and Biomedical Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Mechanical and Aerospace Engineering, Anatomy and Neurobiology, and Biomedical Engineering, University of California, 4200 Engineering Gateway, Irvine, CA 92697-3875 Irvine</wicri:regionArea><placeName><region type="state">Californie</region></placeName></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>Practicing arm and gait movements with robotic assistance after neurologic injury can help patients improve their movement ability, but patients sometimes reduce their effort during training in response to the assistance. Reduced effort has been hypothesized to diminish clinical outcomes of robotic training. To better understand patient slacking, we studied the role of visual distraction and auditory feedback in modulating patient effort during a common robot-assisted tracking task.</p></sec><sec><title>Methods</title><p>Fourteen participants with chronic left hemiparesis from stroke, five control participants with chronic right hemiparesis and fourteen non-impaired healthy control participants, tracked a visual target with their arms while receiving adaptive assistance from a robotic arm exoskeleton. We compared four practice conditions: the baseline tracking task alone; tracking while also performing a visual distracter task; tracking with the visual distracter and sound feedback; and tracking with sound feedback. For the distracter task, symbols were randomly displayed in the corners of the computer screen, and the participants were instructed to click a mouse button when a target symbol appeared. The sound feedback consisted of a repeating beep, with the frequency of repetition made to increase with increasing tracking error.</p></sec><sec><title>Results</title><p>Participants with stroke halved their effort and doubled their tracking error when performing the visual distracter task with their left hemiparetic arm. With sound feedback, however, these participants increased their effort and decreased their tracking error close to their baseline levels, while also performing the distracter task successfully. These effects were significantly smaller for the participants who used their non-paretic arm and for the participants without stroke.</p></sec><sec><title>Conclusions</title><p>Visual distraction decreased participants effort during a standard robot-assisted movement training task. This effect was greater for the hemiparetic arm, suggesting that the increased demands associated with controlling an affected arm make the motor system more prone to slack when distracted. Providing an alternate sensory channel for feedback, i.e., auditory feedback of tracking error, enabled the participants to simultaneously perform the tracking task and distracter task effectively. 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Wasserthiel-Smoller</name></author><author><name sortKey="Wong, Nd" uniqKey="Wong N">ND Wong</name></author><author><name sortKey="Wylie Rosett, J" uniqKey="Wylie Rosett J">J Wylie-Rosett</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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