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1.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(8. Vyp. 2): 30-36, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33016674

RESUMO

BACKGROUND: The issue of the diagnostic significance and clinical value of neuron-specific enolase (NSE) and brain-derived neurotropic factor (BDNF) in the acute period of stroke remains controversial. Therefore, it is advisable to study the correlation of biomarkers with the clinical characteristics of stroke in the time period of early recovery. OBJECTIVE: To monitor NSE and BDNF levels in peripheral blood, to analyze the clinical and laboratory correlations in patients with ischemic stroke at the stages of medical rehabilitation in the early recovery period. MATERIAL AND METHODS: Forty-nine patients with ischemic stroke in the middle cerebral artery were examined. The observation period is 90 days. Observation Points are Day 1; Day 14; Day 45; Day 90. The National Institute of Health Stroke Scale (NIHSS), the Fugle-Meyer Scale (FMA), the Modified Rankin Scale (mRS) were administered. NSE was determined in blood serum by enzyme-linked immunosorbent assay, BDNF was analyzed on a multiplex analyzer. RESULTS AND CONCLUSION: NSEDay1 in patients was significantly higher than in the comparison group (pDay1-comparison group<0.001) with a trend to a maximum decrease on the 90th day of stroke (pDay1-90<0.001). BDNFDay1 turned out to be lower than in the comparison group (pDay1-comparison group=0.006) and significantly increased by the 14th day of the stroke (pDay1-14<0.001; pDay14-comparison group=0.637). A negative correlation was found between a decrease in NSEDay14 and an increase in BDNFDay14 (r= -0.349; p=0.05). A positive correlation was found between an increase in BDNFDay14 and a decrease in mRS scores Day90 (r=0.499, p=0.035). Outcomes in patients in group 1 (after stages I and II of rehabilitation) on the assessment scales were significantly better than in patients discharged after stage I for outpatient monitoring - group 2 (p<0.05). In group 1, BDNFDay90 did not differ from BDNFDay14 (pDay14-90-Group1=0.17), and in group 2 it was significantly lower by the end of the early recovery period (pDay14-90-Group2=0.002).


Assuntos
Isquemia Encefálica , Acidente Vascular Cerebral , Encéfalo , Fator Neurotrófico Derivado do Encéfalo , Humanos , Fosfopiruvato Hidratase , Reabilitação do Acidente Vascular Cerebral
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(8. Vyp. 2): 73-80, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33016680

RESUMO

OBJECTIVE: To compare the efficacy of walking function recovery in patients in the early recovery period of ischemic stroke (IS) using an exoskeleton for the lower extremities and an active-passive pedal exercise bike. MATERIAL AND METHODS: An open randomized study of 47 patients in the early recovery period of IS was conducted. The rehabilitation course included exercises on an ExoAtlet exoskeleton in group 1 and exercises on a pedal simulator for active-passive training (5 days a week for 2 weeks) in group 2. Several tests were used to evaluate treatment results, including the Hauser walking index, the 10-meter walking test, the Berg balance scale, stabilometry, and biomechanics of walking. The complete training course was completed by 20 patients of group 1 and 21 of group 2. RESULTS: There was a significant increase in strength in paretic muscles, postural stability, functional level and walking speed in patients of both groups, but in patients of group 1, the dynamics of recovery was more pronounced (p<0.05). In group 1, there was a significant decrease in the level of disability and an increase in daily activity, which was higher compared to group 2. An analysis of the main indicators of the statokinesiogram showed the more pronounced positive shifts in patients of group 1, but significant differences were found only in the dynamics of the length and area of the curve in the test with eyes open. When studying the biomechanics of walking, it was found that the function of walking was changed: there was a significant decrease in the speed of movement by 2.2 times, the length of a double step by 1.6 times, and the pace of walking by 1.3 times compared to normal indicators. After the end of exercises, a significant increase in the length of the double step, speed and pace of walking as well as a decrease in the period of the locomotor cycle were found in group 1. CONCLUSION: The study revealed a positive impact of hardware rehabilitation on locomotion, both with the use of an exoskeleton and an active-passive pedal simulator. The use of an exoskeleton, have the advantages resulting in a significantly greater recovery of strength, stability, speed and symmetry of walking over the same period of training. A significant increase in postural stability in vertical position was revealed.


Assuntos
Exoesqueleto Energizado , Procedimentos Cirúrgicos Robóticos , Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Caminhada
3.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(8. Vyp. 2): 81-87, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33016681

RESUMO

The pandemic of the new coronavirus infection caused by SARS-CoV-2 has forced to reconsider the methods of rehabilitation of patients with emergency conditions, including neurology. The Council of Experts of Neurologists and Rehabilitation Therapists gathered to develop unified approaches to manage stroke patients based on a discussion of practical experience and, taking into account the scientific information on COVID-19 that was available by the time of the meeting. Stroke is a serious disabling condition that requires maximum rehabilitation efforts at all stages of medical care. In the context of the SARS-CoV-2 coronavirus epidemic, the process of medical rehabilitation and the routing of patients with stroke is undergoing major changes. Combining COVID-19 and stroke requires new approaches to rehabilitation and patient management. During the meeting, a resolution was developed in which the experts formulated the tactics of medical rehabilitation of patients with stroke and COVID-19 at the first and second stages. The arguments of the importance and practicability of carrying out measures of medical rehabilitation at the third stage is given and the need to continue consultations on the indicated topic is revealed.


Assuntos
Infecções por Coronavirus , Coronavirus , Pandemias , Pneumonia Viral , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Betacoronavirus , Humanos
4.
J Stroke Cerebrovasc Dis ; 29(11): 105182, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33066878

RESUMO

Infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the development of the novel 2019 coronavirus disease (COVID-19) and associated clinical symptoms, which typically presents as an upper respiratory syndrome such as pneumonia. Growing evidence indicates an increased prevalence of neurological involvement (e.g., in the form of stroke) during virus infection. COVID-19 has been suggested to be more than a lung infection because it affects the vasculature of the lungs and other organs and increases the risk of thrombosis. Patients with stroke are vulnerable to secondary events as a result not only of their poor vascular condition but also of their lack of access to rehabilitation resources. Herein, we review current knowledge regarding the pathophysiology of COVID-19, its possible association with neurological involvement, and current drug therapies. Suggestions are also offered regarding the potential for current neurorehabilitation therapies to be taught and practiced at home.


Assuntos
Infecções por Coronavirus/terapia , Modalidades de Fisioterapia , Pneumonia Viral/terapia , Prevenção Secundária , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Quarentena , Recuperação de Função Fisiológica , Recidiva , Fatores de Risco , Distância Social , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4330-4336, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018954

RESUMO

After a stroke, individuals often exhibit upper extremity (UE) motor dysfunction, influencing the performance of everyday tasks. Characterizing UE movements is useful to track recovery and response to intervention. Yet, due to the complexity of the recovery process, UE movements may be extremely variable and person-specific. While this renders automatic recognition of these gestures challenging, machine learning methods could be used to classify UE movements in atypical populations. In the current study, we utilize data from 20 individuals post-stroke and 20 age-matched controls to identify an optimal set of sensor-extracted features for the classification of unimanual and bimanual gestures during task performance. We found that using fewer than 100 features along with a random forest classifier produced the best performance across both groups, with both user-dependent and user-independent models.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Aprendizado de Máquina , Movimento , Extremidade Superior
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4867-4872, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019080

RESUMO

We have developed HandMATE (Hand Movement Assisting Therapy Exoskeleton); a wearable motorized hand exoskeleton for home-based movement therapy following stroke. Each finger and the thumb is powered by a linear actuator which provides flexion and extension assistance. Force sensitive resistors integrated into the design measure grasp and extension initiation force. An assistive therapy mode is based on an admittance control strategy. We evaluated our control system via subject and bench testing. Errors during a grip force tracking task while using the HandMATE were minimal (<1%) and comparable to unassisted healthy hand performance. We also outline a dedicated app we have developed for optimal use of HandMATE at home. The exoskeleton communicates wirelessly with an Android tablet which features guided exercises, therapeutic games and performance feedback. We surveyed 5 chronic stroke patients who used the HandMATE device to further evaluate our system, receiving positive feedback on the exoskeleton and integrated app.


Assuntos
Exoesqueleto Energizado , Procedimentos Cirúrgicos Robóticos , Reabilitação do Acidente Vascular Cerebral , Dispositivos Eletrônicos Vestíveis , Mãos , Humanos
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4878-4881, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019082

RESUMO

Significant hand and upper-limb impairment is common post-stroke. Robotic training can administer a high-dose of repetitive movement training to stroke survivors, but its efficacy can be further improved by targeting specific impairments of individual patients. In this study, we developed a new robotic training protocol that identifies specific impairment patterns that degrade functional performance of individual patients and provide joint-specific assistance to counteract subject-specific impairments. The target tasks were also adjusted based on their task performance during training. Two chronic stroke survivors participated in a pilot training study to demonstrate the efficacy of the proposed impairment-based robotic training. Upper limb function of the participants was improved by the proposed training as shown in the clinical tests (6.5 ± 4.5 increase in Fugl-Meyer; 10 ± 6.9 increase in Action Research Arm Test), and the laboratory tests also showed improvement in their range of motion (hand) and voluntary reaching distance (arm). The impairment-based robotic training targeted (and improved) specific deficits of individual patients that hampered their task performance, which could have contributed to the observed functional improvement. The proposed training can enhance the rehabilitative outcome of robotic training by emphasizing the key components of effective rehabilitation, i.e., subject-specific, impairment-based training.Clinical Relevance- This study shows that impairment-based, 'subject-specific' robotic trainings can improve upper extremity function of stroke survivors.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Reabilitação do Acidente Vascular Cerebral , Humanos , Movimento , Extremidade Superior
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4886-4889, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019084

RESUMO

Recovering of upper extremity functions is important for stroke patients to perform various tasks in daily life. For better rehabilitation outcomes and accurate measurement, robot assisted exercises have been developed. However, there are limited number of studies related to arm muscles activities corresponding to task complexity. We conducted a preliminary case study on strategy and activities of upper extremity muscles in a healthy volunteer at reaching exercise with haptic feedback by a robot with seven degree-of-freedom when a different target was presented in the virtual environment. Impedance control for Franka Emika Panda robot arm has been developed. The study protocol consisted of 4 sets of 40 reaching trials. The trials had two modes with two different feedback: big target task mode and the small target task mode. In each mode both options, with/without haptic feedback were tested. The preliminary results suggest that different distance to target and target's size is related to the change of activation order and intensity of muscle activities at reaching task. Additionally, the haptic feedback required different activation order and higher intensity regardless of the task difficulty.


Assuntos
Robótica , Reabilitação do Acidente Vascular Cerebral , Terapia por Exercício , Humanos , Movimento , Extremidade Superior
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4959-4962, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019100

RESUMO

This paper outlines the construction, current state, and future goals of HERCULES, a three degree-of-freedom (DoF) pneumatically actuated exoskeleton for stroke rehabilitation. The exoskeleton arm is capable of joint-angle control at the elbow in flexion and extension, at the shoulder in flexion and extension, and at the shoulder in abduction and adduction. In the near future we plan to embed kinematic synergies into the control system architecture of this arm to gain dexterous and near-natural movements.Clinical Relevance- This device can be used as an upper limb rehabilitation testbed for individuals with complete or partial upper limb paralysis. In the future, this system can be used to train individuals on synergy-based rehabilitation protocols.


Assuntos
Exoesqueleto Energizado , Reabilitação do Acidente Vascular Cerebral , Cotovelo , Humanos , Amplitude de Movimento Articular , Extremidade Superior
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3763-3766, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018820

RESUMO

Rehabilitation level evaluation is an important part of the automatic rehabilitation training system. As a general rule, this process is manually performed by rehabilitation doctors using chart-based ordinal scales which can be both subjective and inefficient. In this paper, a novel approach based on ensemble learning is proposed which automatically evaluates stroke patients' rehabilitation level using multi-channel sEMG signals to this problem. The correlation between rehabilitation levels and rehabilitation training actions is investigated and actions suitable for rehabilitation assessment are selected. Then, features are extracted from the selected actions. Finally, the features are used to train the stacking classification model. Experiments using sEMG data collected from 24 stroke patients have been carried out to examine the validity and feasibility of the proposed method. The experiment results show that the algorithm proposed in this paper can improve the classification accuracy of 6 Brunnstrom stages to 94.36%, which can promote the application of home-based rehabilitation training in practice.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Algoritmos , Humanos
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3771-3774, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018822

RESUMO

Muscle networks represent a series of interactions among muscles in the central nervous system's effort to reduce the redundancy of the musculoskeletal system in motor-control. How this occurs has only been investigated recently in healthy subjects with a novel technique exploring the functional connectivity between muscles through intermuscular coherence (IMC), yet the potential value of this method in characterizing the alteration of muscular networks after stroke remains unknown. In this study, muscle networks were assessed in post-stroke survivors and healthy controls to identify possible alterations in the neural oscillatory drive to muscles after stroke. Surface electromyography (sEMG) was collected from eight key upper extremity muscles to non-invasively determine the common neural input to the spinal motor neurons innervating muscle fibers. Coherence was computed between all possible muscle pairs and further decomposed by non-negative matrix factorization (NMF) to identify the common spectral patterns of coherence underlying the muscle networks. Results suggested that the number of identified muscle networks during dynamic force generation decreased after stroke. The findings in this study could provide a new prospective for understanding the motor control recovery during post-stroke rehabilitation.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Músculo Esquelético , Estudos Prospectivos , Sobreviventes
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3831-3834, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018836

RESUMO

Upper extremity motor function loss severely affects stroke survivors during daily life activities. Different rehabilitation robotic systems have been developed to allow stroke survivors regain their motor function. Meanwhile, most of the robots only operate in a passive mode and restrict the users to navigate predefined trajectories which may not align with their motion intent, thus limiting motor recovery. One way to resolve this issue would be to utilize a decoded movement intent to trigger intuitively active motor training for patients. In this direction, this study proposed and investigated the use of spatial-temporal neuromuscular descriptor (STD) for optimal decoding of multiple patterns of movement intents in patient to provide inputs for active motor training in the rehabilitation robotic systems. The STD performance was validated using High-Density surface electromyogram recordings from five stroke survivors who performed 21 limb movements. Experimental results show that the STD achieved a significant reduction in limb movement classification error (13.36%) even in the presence of the inevitable White Gaussian Noise compared to other methods (p<0.05). The STD also showed obvious class separability for individual movement. Findings from this study suggest that the STD may provide potential inputs for intuitively active motor training in stroke rehabilitation robotic systems.Clinical Relevance- This study showed that spatial-temporal neuromuscular information could aid adequate decoding of movement intents upon which intuitively active motor training could be achieved in stroke rehabilitation robotic systems.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Intenção , Sobreviventes , Extremidade Superior
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5773-5776, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019286

RESUMO

After a cerebral stroke, survivors need to follow a neurorehabilitation program including exercises to be executed under a therapist's supervision or autonomously. Technological solutions are needed to support the early discharge of the patients just after the primary hospital treatments, by still providing an adequate level of rehabilitation. The DoMoMEA Project proposes a fully-wearable m-health solution able to administer a neurorehabilitation therapy in the patient's home or every other place established by the patient for a rehabilitation session. The exploitation of magneto-inertial measurement units only, wirelessly connected to an Android-operated device, provides robustness to different operating conditions and immunity to optical occlusion problems, compared to RGB-D cameras. Patients' engagement is fostered by the exploitation of the exergame version of the ten rehabilitation exercises, implemented in Unity 3D. Store-and-forward telemonitoring features, supported by cloud-based storage and by a web application accessible from anywhere by medical personnel and patients, enable constant transparent monitoring of the rehabilitation progresses. The clinical trial of the DoMoMEA telerehabilitation system will involve 40 post-stroke patients with mild impairment and will start as soon as the restrictions due to the COVID-19 pandemic will allow to enroll patients.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Telerreabilitação , Betacoronavirus , Infecções por Coronavirus , Humanos , Pandemias , Pneumonia Viral
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5757-5760, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019282

RESUMO

In this paper, we present the design and development of a game-assisted stroke rehabilitation system RehabFork that allows a user to train their upper-limb to perform certain functions related to the task of eating. The task of eating is divided into several components: (i) grasping the eating utensils such as a fork and knife; (ii) lifting the eating utensils; (iii) using the eating utensils to cut a piece of food; (iv) transferring the food to the mouth; and (v) chewing the food. The RehabFork supports the user through sub-tasks (i)-(iii). The hardware components of RehabFork consist of an instrumented fork and knife, and a 3D printed pressure pad, that measure and communicate information on user performance to a gaming environment to render an integrated rehabilitation system. The gaming environment consists of an interactive game that utilizes sensory data as well as user information about the severity of their disability and current level of progress to adjust the difficulty levels of the game to maintain user motivation. Information pertaining to the user, including performance data, is stored and can be shared with care providers for ongoing oversight.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Motivação , Extremidade Superior
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 588-591, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018057

RESUMO

Stroke survivors are often characterized by hemiparesis, i.e., paralysis in one half of the body, that severely affects upper limb movements. Continuous monitoring of the progression of hemiparesis requires manual observation of the limb movements at regular intervals and hence is a labour intensive process. In this work, we use wrist-worn accelerometers for automated assessment of hemiparetic severity in acute stroke patients through bivariate Poincaré analysis between accelerometer data from the two hands during spontaneous and instructed movements. Experiments show that while the bivariate Poincaré descriptors CSD1 and CSD2 can identify hemiparetic patients from control subjects, a novel descriptor called Complex Cross-Correlation Measure (C3M) can distinguish between moderate and severe hemiparesis. Further, we justify the use of C3M by showing that it is described by multiple-lag cross-correlations, representing the co-ordination of activity between two hands. The descriptors are compared against the National Institutes of Health Stroke Scale (NIHSS), the clinical gold standard for evaluation of hemiparetic severity, and studied using statistical tests for developing supervised models for hemiparesis classification.Clinical relevance-This study establishes the suitability of wrist-worn accelerometers in identifying hemiparetic severity in stroke patients through novel descriptors of hand co-ordination.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Dispositivos Eletrônicos Vestíveis , Acelerometria , Humanos , Paresia/diagnóstico , Acidente Vascular Cerebral/complicações , Estados Unidos
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2841-2844, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018598

RESUMO

Multi-session robot-assisted stroke rehabilitation program requires patients to perform repetitive tasks. It is challenging for the patient to maintain concentration during training sessions. A novel intervention strategy using Electroencephalography (EEG) signals is proposed to maintain concentration during training by enhancing the engagement of stroke patients using robot-assisted multi-session rehabilitation. The approach is illustrated by applying it to one stroke patient undergoing 12 training sessions of hand motor training on the AMADEO rehabilitation device. AMADEO offers four modes of training programs of increased intensity comprising passive training, passive training with biofeedback, assistive training as well as active 2D training games. The EEG signals are measured over eight electrode sites: FC4, C4, CP4, FC3, C3, CP3, Cz, and CPz during each training day to extract movement-related cortical potential (MRCP) signals. Moreover, functional hand recovery parameters are determined using the AMADEO assessment tool. The patient's level of engagement is determined by the negative amplitude of the MRCP signal. The rehabilitation program is switched to a more intense training mode when a consistent decrease is observed in the negative amplitude of MRCP signals from the monitored electrodes. Using this approach, the rehabilitation program becomes patient-specific and adaptive. In addition, it is shown that each training mode exhibits a different recovery level of the affected hand and maximum recovery is achieved when MRCP signals indicate that the patient is actively participating in the training.


Assuntos
Robótica , Reabilitação do Acidente Vascular Cerebral , Eletroencefalografia , Estudos de Viabilidade , Mãos , Humanos
17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3228-3231, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018692

RESUMO

Stroke survivors often experience unilateral sensorimotor impairment. The restoration of upper limb function is an important determinant of quality of life after stroke. Wearable technologies that can measure hand function at home are needed to assess the impact of new interventions. Egocentric cameras combined with computer vision algorithms have been proposed as a means to capture hand use in unconstrained environments, and have shown promising results in this application for individuals with cervical spinal cord injury (cSCI). The objective of this study was to examine the generalizability of this approach to individuals who have experienced a stroke. An egocentric camera was used to capture the hand use (hand-object interactions) of 6 stroke survivors performing daily tasks in a home simulation laboratory. The interaction detection classifier previously trained on 9 individuals with cSCI was applied to detect hand use in the stroke survivors. The processing pipeline consisted of hand detection, hand segmentation, feature extraction, and interaction detection. The resulting average F1 scores for affected and unaffected hands were 0.66 ± 0.25 and 0.80 ± 0.15, respectively, indicating that the approach is feasible and has the potential to generalize to stroke survivors. Using stroke-specific training data may further increase the accuracy obtained for the affected hand.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Dispositivos Eletrônicos Vestíveis , Mãos , Humanos , Qualidade de Vida , Extremidade Superior
18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3240-3243, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018695

RESUMO

Post-stroke rehabilitation, occupational and physical therapy, and training for use of assistive prosthetics leverages our current understanding of bilateral motor control to better train individuals. In this study, we examine upper limb lateralization and model transference using a bimanual joystick cursor task with orthogonal controls. Two groups of healthy subjects are recruited into a 2-session study spaced seven days apart. One group uses their left and right hands to control cursor position and rotation respectively, while the other uses their right and left hands. The groups switch control methods in the second session, and a rotational perturbation is applied to the positional controls in the latter half of each session. We find agreement with current lateralization theories when comparing robustness to feedforward perturbations in feedback and feedforward measures. We find no evidence of a transferable model after seven days, and evidence that the brain does not synchronize task completion between the hands.


Assuntos
Desempenho Psicomotor , Reabilitação do Acidente Vascular Cerebral , Encéfalo , Mãos , Humanos , Extremidade Superior
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3577-3580, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018776

RESUMO

Electrical stimulation of the vagus nerve has been shown to enhance cortical plasticity and may benefit upper extremity rehabilitation following stroke. As an initial step towards assessing the potential of other craniocervical nerves as neuromodulation targets during rehabilitation, we explored the ability of non-invasive stimulation of cervical spine afferents, paired with a proprioceptive discrimination task, to improve sensory function in neurologically intact human subjects. On each trial, subjects' arms were moved by a robot from a test position, along a random path, to a judgment position located 1-4 cm away. Subjects responded 'same' if the judgment position was the same as the test or 'different' if it was not. These responses were used to compute proprioceptive sensitivity and bias. Three groups of 20 subjects received transcutaneous electric nerve stimulation to the C3/C4 cervical spine at one of three frequencies (30 Hz, 300 Hz, 3 kHz) for 10 minutes prior to task performance. A fourth group served as a sham. We found a statistically significant interaction between stimulation frequency and displacement distance on proprioceptive sensitivity. In summary, stimulation of cervical spine afferents may enhance arm proprioceptive function, though in unimpaired subjects these gains depend on both stimulation frequency and discrimination distance.Clinical Relevance- This study provides preliminary data on the potential for non-invasive stimulation of cervical spine afferents to enhance recovery of function following stroke and other neurological disorders.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Estimulação Elétrica Nervosa Transcutânea , Braço , Humanos , Extremidade Superior
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3670-3675, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018797

RESUMO

Digital solutions for unilateral spatial neglect (USN) assessment and treatment are nowadays of great interest, because of both the possibility of combining them with other rehabilitation practices, and the easy-to-understand data and indicators they collect. The ReMoVES platform, developed in DITEN laboratories, is conceived in the Assistive Technologies framework and provides motor and cognitive exergames and activities to be performed in conjunction with traditional rehabilitation. In this work, two case-studies, related to the USN rehabilitation, are presented. The combination of cognitive therapy, delivered by the ReMoVES platform, and transcranial direct-current stimulation (tDCS) technique was used as rehabilitation treatment for both the patients. Data collected at the beginning or at the end of the rehabilitation process, or also during the treatment sessions, are shown and discussed in this paper. This work is a preliminary part of a wider one, that will be conducted involving many different rehabilitation centers, aimed at proving the validity of such an approach to USN treatments.


Assuntos
Medicina , Transtornos da Percepção , Reabilitação do Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Humanos
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