Gradual adaptation to pelvis perturbation during walking reinforces motor learning of weight shift toward the paretic side in individuals post-stroke

2021 ◽  
Author(s):  
Seoung Hoon Park ◽  
Chao-Jung Hsu ◽  
Weena Dee ◽  
Elliot J. Roth ◽  
William Z. Rymer ◽  
...  
Keyword(s):  
Motor Learning ◽  
Post Stroke ◽  
Paretic Side ◽  
Weight Shift

Enhanced error facilitates motor learning in weight shift and increases use of the paretic leg during walking at chronic stage after stroke

2021 ◽  
Author(s):  
Seoung Hoon Park ◽  
Chao-Jung Hsu ◽  
Weena Dee ◽  
Elliot J. Roth ◽  
William Z. Rymer ◽  
...  
Keyword(s):  
Motor Learning ◽  
Chronic Stage ◽  
Weight Shift

Is training with a focus on motor learning effective in improving body coordination in chronic post stroke patients?

2021 ◽  
Vol 429 ◽  
pp. 118583
Author(s):  
Nina Trushkova ◽  
Olga Cochran ◽  
Natalia Ermolina ◽  
Giovanni Zelano
Keyword(s):  
Motor Learning ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals Wrist Actimetry Biomarker Development of Paretic Upper Limb Use in Post Stroke Patients for Ecological Monitoring.

2021 ◽  
Author(s):  
Gilles Dusfour ◽  
Denis Mottet ◽  
Makii Muthalib ◽  
Isabelle Laffont ◽  
Karima K.A. Bakhti
Keyword(s):  
Home Environment ◽  
Upper Limb ◽  
Healthy Subjects ◽  
Limiting Factors ◽  
Cumulative Probability ◽  
Limiting Factor ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Post Stroke ◽  
Paretic Side

Abstract Background In post-stroke patients it is unclear which wrist actimetry biomarkers to use to estimate the degree of upper limb hemiparesis. The objective of this study was to develop a general and objective framework for monitoring hemiparetic patients in their home environment via different biomarkers based on 7 days of actimetry data. A secondary objective was to use all of these biomarkers to better understand the mechanism for potential non-use of the paretic upper limb. Methods Accelerometers were worn continuously for a period of 7 days on both wrists of 10 post-stroke hemiparetic patients as well as 6 healthy subjects. Various wrist actimetry biomarkers were calculated, including the Jerk ratio 50 (JR50, cumulative probability that the Jerk Ratio is between 0 and 0.5), absolute and relative amounts of functional use of movements of the upper limbs (FuncUse and FuncUseR) and absolute and relative velocities of the upper limbs during functional use (VUL and VULR). For each biomarker, the values of stroke and healthy groups were compared. The correlations between all the biomarkers were studied. Results We studied 10 participants with mild-to-moderate chronic hemiparesis and 6 healthy control participants. FuncUse and VUL of the paretic upper limb of stroke patients were significantly lower than in the non-dominant upper limb of healthy subjects. Similarly, FuncUseR (paretic/non-paretic vs non-dominant/dominant), JR and VULR are significantly lower in stroke patients than in healthy subjects. FuncUseR, VULR and JR50 seem to be complementary biomarkers for monitoring patient strokes. Conclusion The stroke patients do not seem to compensate for the decrease in functional movement on the paretic side by an increase on the non-paretic side. The speed of execution of functional movements on the paretic side could be the limiting factor to a normal use of the paretic upper limb. A thorough clinical study is needed to identify the limiting factors. In conclusion, this study for the first time has shown actimetry is a robust and non-obtrusive lightweight technology for continuously acquiring objective upper limb data of paretic arm use/ non-use over an extended period in a home environment for monitoring stroke patients.

scholarly journals Changes in Muscle Activity with Assistance Level During Exoskeletal Gait in Acute Stroke

2021 ◽  
Author(s):  
Ben P.F. O'Callaghan ◽  
Matthew W. Flood ◽  
Michele Tonellato ◽  
Caitríona Fingleton ◽  
Madeleine M Lowery ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Lower Limb ◽  
Muscle Activity ◽  
Stroke Care ◽  
Acute Stage ◽  
Plantar Flexors ◽  
Post Stroke ◽  
Paretic Side ◽  
Gait Parameters ◽  
Cord Injury

Abstract BackgroundThe level of assistance provided to the user is an important decision in rehabilitation training using robotic devices. Both fully assistive and assist-as-needed paradigms have shown benefits in functional outcomes in healthy individuals and users with chronic stroke and spinal cord injury. The effect of assistance level on muscle activity and kinematic gait parameters has not yet been directly examined during overground exoskeletal gait in a stroke population. Furthermore, it is not clear whether an assist-as-needed approach could elicit increased voluntary activity in individuals in the acute stages of stroke. The aim of this study was to examine the effect of assistance level on muscle activity and kinematic parameters during exoskeleton gait in individuals in the acute stage of stroke care.MethodsNine individuals in the acute stage of post-stroke care performed walking tasks in the EKSO GTTM exoskeleton using both maximal assistance and adaptive assistance control paradigms. Temporal gait parameters and muscle activity were recorded using accelerometers and surface EMG on the lower limb muscles.ResultsShorter swing times and longer double support times were observed on the non-paretic side during adaptive assist mode than with maximum assist mode (p<0.0065). No significant effect of exoskeleton mode was observed on the remaining temporal gait parameters. On the paretic side, proximal lower limb muscles (RF and ST) and plantar-flexors (SO) (p<0.00125) exhibited greater activation in adaptive assist mode than in maximum assist mode. On the non-paretic side however, the lower limb distal muscles (TA and SO) displayed greater activity during maximum assist mode than adaptive assist mode (p<0.00125). ConclusionsThe level of assistance provided by an exoskeleton in the acute stages of stroke care is an important clinical decision. The results indicate that an adaptive or assist-as-needed approach elicits higher levels of activation in muscles acting around the knee joint and plantar-flexors on the paretic side than a maximal, fixed assistance paradigm, in the acute stage post-stroke. Increased activity around the ankle joint during maximum assistance mode was also noted. Improved understanding of the effect of assistance level can help inform future control paradigms for exoskeleton gait in acute stroke.

The applicability of motor learning to neurorehabilitation

2015 ◽  
pp. 55-64 ◽  
Author(s):  
John W. Krakauer
Keyword(s):  
Motor Learning ◽  
Brain Stimulation ◽  
Chronic Phase ◽  
Sensitive Period ◽  
Biological Recovery ◽  
Learning Mechanism ◽  
Post Stroke ◽  
Non Invasive

Rehabilitation is a form of directed training and is therefore predicated on the idea that patients respond to such training by learning. Current concepts in motor learning are reviewed. Recovery is not synonymous with re-learning and that it is important to be specific about what learning mechanism is being targeted by any given therapy. There is a unique milieu of heightened plasticity post-stroke that is responsible for reduction in impairment both through spontaneous biological recovery and increased responsiveness to training. In the chronic phase of stroke, plasticity returns to normal levels and learning for the most part only leads to task-specific compensation. Thus, new forms of intervention may have quite distinct effects depending on whether they are initiated in the sensitive period after stroke or in the chronic phase. It is to be hoped that new pharmacological and non-invasive brain stimulation approaches will allow the post-stroke sensitive period to be augmented, extended, and re-opened.

scholarly journals Motor learning in post stroke subjects: the effects of practice conditions on the temporal synchronization

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Camila Torriani-Pasin ◽  
Giordano Marcio Gatinho Bonuzzi ◽  
Gisele Carla dos Santos Palma ◽  
Andrea Michele Freudenheim ◽  
Umberto Cesar Corrêa
Keyword(s):  
Motor Learning ◽  
Temporal Synchronization ◽  
Post Stroke
Sign in / Sign up

Export Citation Format

Share Document