Proprioceptive Augmentation With Illusory Kinaesthetic Sensation in Stroke Patients Improves Movement Quality in an Active Upper Limb Reach-and-Point Task.

Autor:	Ferrari F; The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.; Department of Excellence in Robotics & A.I., Scuola Superiore Sant'Anna, Pisa, Italy., Shell CE; Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute-Cleveland Clinic, Cleveland, OH, United States.; Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States., Thumser ZC; Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute-Cleveland Clinic, Cleveland, OH, United States.; Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States., Clemente F; The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.; Department of Excellence in Robotics & A.I., Scuola Superiore Sant'Anna, Pisa, Italy., Plow EB; Department of Biomedical Engineering, Lerner Research Institute-Cleveland Clinic, Cleveland, OH, United States.; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, United States., Cipriani C; The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.; Department of Excellence in Robotics & A.I., Scuola Superiore Sant'Anna, Pisa, Italy., Marasco PD; Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute-Cleveland Clinic, Cleveland, OH, United States.; Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neurorobotics [Front Neurorobot] 2021 Mar 01; Vol. 15, pp. 610673. Date of Electronic Publication: 2021 Mar 01 (Print Publication: 2021).
DOI:	10.3389/fnbot.2021.610673
Abstrakt:	Stroke patients often have difficulty completing motor tasks even after substantive rehabilitation. Poor recovery of motor function can often be linked to stroke-induced damage to motor pathways. However, stroke damage in pathways that impact effective integration of sensory feedback with motor control may represent an unappreciated obstacle to smooth motor coordination. In this study we investigated the effects of augmenting movement proprioception during a reaching task in six stroke patients as a proof of concept. We used a wearable neurorobotic proprioceptive feedback system to induce illusory kinaesthetic sensation by vibrating participants' upper arm muscles over active limb movements. Participants were instructed to extend their elbow to reach-and-point to targets of differing sizes at various distances, while illusion-inducing vibration (90 Hz), sham vibration (25 Hz), or no vibration was applied to the distal tendons of either their biceps brachii or their triceps brachii. To assess the impact of augmented kinaesthetic feedback on motor function we compared the results of vibrating the biceps or triceps during arm extension in the affected arm of stroke patients and able-bodied participants. We quantified performance across conditions and participants by tracking limb/hand kinematics with motion capture, and through Fitts' law analysis of reaching target acquisition. Kinematic analyses revealed that injecting 90 Hz illusory kinaesthetic sensation into the actively contracting (agonist) triceps muscle during reaching increased movement smoothness, movement directness, and elbow extension. Conversely, injecting 90 Hz illusory kinaesthetic sensation into the antagonistic biceps during reaching negatively impacted those same parameters. The Fitts' law analyses reflected similar effects with a trend toward increased throughput with triceps vibration during reaching. Across all analyses, able-bodied participants were largely unresponsive to illusory vibrational augmentation. These findings provide evidence that vibration-induced movement illusions delivered to the primary agonist muscle involved in active movement may be integrated into rehabilitative approaches to help promote functional motor recovery in stroke patients. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Ferrari, Shell, Thumser, Clemente, Plow, Cipriani and Marasco.)
Databáze:	MEDLINE
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