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Impairment-Based 3-D Robotic Intervention Improves Upper Extremity Work Area in Chronic Stroke: Targeting Abnormal Joint Torque Coupling With Progressive Shoulder Abduction Loading

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Impairment-Based 3-D Robotic Intervention Improves Upper Extremity Work Area in Chronic Stroke: Targeting Abnormal Joint Torque Coupling With Progressive Shoulder Abduction Loading

Auteurs : Michael D. Ellis ; Theresa M. Sukal-Moulton ; Julius P. A. Dewald

Source :

IEEE transactions on robotics : a publication of the IEEE Robotics and Automation Society [ 1552-3098 ] ; 2009.

RBID : PMC:2908491

Abstract

The implementation of a robotic system (ACT^3D) that allowed for a quantitative measurement of abnormal joint torque coupling in chronic stroke survivors and, most importantly, a quantitative means of initiating and progressing an impairment-based intervention, is described. Individuals with chronic moderate to severe stroke (n = 8) participated in this single-group pretest-posttest design study. Subjects were trained over eight weeks by progressively increasing the level of shoulder abduction loading experienced by the participant during reaching repetitions as performance improved. Reaching work area was evaluated pre- and postintervention for ten different shoulder abduction loading levels along with isometric single-joint strength and a qualitative clinical assessment of impairment. There was a significant effect of session (pre versus post) with an increase in reaching work area, despite no change in single-joint strength. This data suggests that specifically targeting the abnormal joint torque coupling impairment through progressive shoulder abduction loading is an effective strategy for improving reaching work area following hemiparetic stroke. Application of robotics, namely, the ACT^3D, allowed for quantitative control of the exercise parameters needed to directly target the synergistic coupling impairment. The targeted reduction of abnormal joint torque coupling is likely the key factor explaining the improvements in reaching range of motion achieved with this intervention.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908491

DOI: 10.1109/TRO.2009.2017111
PubMed: 20657711
PubMed Central: 2908491

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Le document en format XML

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<author><name sortKey="Ellis, Michael D" sort="Ellis, Michael D" uniqKey="Ellis M" first="Michael D." last="Ellis">Michael D. Ellis</name>
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<author><name sortKey="Sukal Moulton, Theresa M" sort="Sukal Moulton, Theresa M" uniqKey="Sukal Moulton T" first="Theresa M." last="Sukal-Moulton">Theresa M. Sukal-Moulton</name>
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<author><name sortKey="Dewald, Julius P A" sort="Dewald, Julius P A" uniqKey="Dewald J" first="Julius P. A." last="Dewald">Julius P. A. Dewald</name>
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<author><name sortKey="Ellis, Michael D" sort="Ellis, Michael D" uniqKey="Ellis M" first="Michael D." last="Ellis">Michael D. Ellis</name>
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<author><name sortKey="Sukal Moulton, Theresa M" sort="Sukal Moulton, Theresa M" uniqKey="Sukal Moulton T" first="Theresa M." last="Sukal-Moulton">Theresa M. Sukal-Moulton</name>
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<author><name sortKey="Dewald, Julius P A" sort="Dewald, Julius P A" uniqKey="Dewald J" first="Julius P. A." last="Dewald">Julius P. A. Dewald</name>
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<series><title level="j">IEEE transactions on robotics : a publication of the IEEE Robotics and Automation Society</title>
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<front><div type="abstract" xml:lang="en"><p id="P1">The implementation of a robotic system (ACT<sup>3D</sup>
) that allowed for a quantitative measurement of abnormal joint torque coupling in chronic stroke survivors and, most importantly, a quantitative means of initiating and progressing an impairment-based intervention, is described. Individuals with chronic moderate to severe stroke (<italic>n</italic>
 = 8) participated in this single-group pretest-posttest design study. Subjects were trained over eight weeks by progressively increasing the level of shoulder abduction loading experienced by the participant during reaching repetitions as performance improved. Reaching work area was evaluated pre- and postintervention for ten different shoulder abduction loading levels along with isometric single-joint strength and a qualitative clinical assessment of impairment. There was a significant effect of session (pre versus post) with an increase in reaching work area, despite no change in single-joint strength. This data suggests that specifically targeting the abnormal joint torque coupling impairment through progressive shoulder abduction loading is an effective strategy for improving reaching work area following hemiparetic stroke. Application of robotics, namely, the ACT<sup>3D</sup>
, allowed for quantitative control of the exercise parameters needed to directly target the synergistic coupling impairment. The targeted reduction of abnormal joint torque coupling is likely the key factor explaining the improvements in reaching range of motion achieved with this intervention.</p>
</div>
</front>
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  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">101514509</journal-id>
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<article-id pub-id-type="manuscript">NIHMS175933</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Impairment-Based 3-D Robotic Intervention Improves Upper Extremity Work Area in Chronic Stroke: Targeting Abnormal Joint Torque Coupling With Progressive Shoulder Abduction Loading</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ellis</surname>
<given-names>Michael D.</given-names>
</name>
<email>m-ellis@northwestern.edu</email>
<aff id="A1">Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611 USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sukal-Moulton</surname>
<given-names>Theresa M.</given-names>
</name>
<role>Student Member IEEE</role>
<email>t-sukal@northwestern.edu</email>
<aff id="A2">Department of Biomedical Engineering and the Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611 USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dewald</surname>
<given-names>Julius P. A.</given-names>
</name>
<role>Member IEEE</role>
<email>j-dewald@northwestern.edu</email>
<aff id="A3">Department of Biomedical Engineering, Department of Physical Therapy and Human Movement Sciences, and the Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611 USA</aff>
</contrib>
</contrib-group>
<pub-date pub-type="nihms-submitted"><day>17</day>
<month>2</month>
<year>2010</year>
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<pub-date pub-type="ppub"><day>1</day>
<month>6</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>22</day>
<month>7</month>
<year>2010</year>
</pub-date>
<volume>25</volume>
<issue>3</issue>
<fpage>549</fpage>
<lpage>555</lpage>
<abstract><p id="P1">The implementation of a robotic system (ACT<sup>3D</sup>
) that allowed for a quantitative measurement of abnormal joint torque coupling in chronic stroke survivors and, most importantly, a quantitative means of initiating and progressing an impairment-based intervention, is described. Individuals with chronic moderate to severe stroke (<italic>n</italic>
 = 8) participated in this single-group pretest-posttest design study. Subjects were trained over eight weeks by progressively increasing the level of shoulder abduction loading experienced by the participant during reaching repetitions as performance improved. Reaching work area was evaluated pre- and postintervention for ten different shoulder abduction loading levels along with isometric single-joint strength and a qualitative clinical assessment of impairment. There was a significant effect of session (pre versus post) with an increase in reaching work area, despite no change in single-joint strength. This data suggests that specifically targeting the abnormal joint torque coupling impairment through progressive shoulder abduction loading is an effective strategy for improving reaching work area following hemiparetic stroke. Application of robotics, namely, the ACT<sup>3D</sup>
, allowed for quantitative control of the exercise parameters needed to directly target the synergistic coupling impairment. The targeted reduction of abnormal joint torque coupling is likely the key factor explaining the improvements in reaching range of motion achieved with this intervention.</p>
</abstract>
<kwd-group><title>Index Terms</title>
<kwd>Arm</kwd>
<kwd>kinematics</kwd>
<kwd>kinetics</kwd>
<kwd>rehabilitation robotics</kwd>
<kwd>stroke</kwd>
</kwd-group>
<contract-num rid="HD1">R42 HD049923-02
				||HD</contract-num>
<contract-sponsor id="HD1">National Institute of Child Health & Human Development : NICHD</contract-sponsor>
</article-meta>
</front>
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Impairment-Based 3-D Robotic Intervention Improves Upper Extremity Work Area in Chronic Stroke: Targeting Abnormal Joint Torque Coupling With Progressive Shoulder Abduction Loading

Impairment-Based 3-D Robotic Intervention Improves Upper Extremity Work Area in Chronic Stroke: Targeting Abnormal Joint Torque Coupling With Progressive Shoulder Abduction Loading

Source :

Abstract

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