Cognitive-Motor Interference on Upper Extremity Motor Performance in a Robot-Assisted Planar Reaching Task Among Patients With Stroke

Objective:To test the hypothesis that cognitive demands influence motor performance during recovery from acute stroke, we tested acute stroke patients on two motor tasks with different cognitive demands and related task performance to cognitive impairment and neuroanatomic injury.Methods:We assessed the contralesional and ipsilesional upper extremities of a cohort of 50 patients with weakness after unilateral acute ischemic stroke at three timepoints with two tasks: the Box & Blocks Test, a task with greater cognitive demand, and Grip Strength, a simple and ballistic motor task. We compared performance on the two tasks, related motor performance to cognitive dysfunction, and used voxel-based lesion symptom mapping to determine neuroanatomical sites associated with motor performance.Results:Consistent across contralesional and ipsilesional upper extremities and most pronounced immediately post-stroke, Box & Blocks scores were significantly more impaired than Grip Strength scores. The presence of cognitive dysfunction significantly explained up to 33% of variance in Box & Blocks performance but was not associated with Grip Strength performance. While Grip Strength performance was associated with injury largely restricted to sensorimotor regions, Box & Blocks performance was associated with broad injury outside sensorimotor structures, particularly the dorsal anterior insula, a region known to be important for complex cognitive function.Conclusions:Altogether, these results suggest that cognitive demands influence upper extremity motor performance during recovery from acute stroke. Our findings emphasize the integrated nature of motor and cognitive systems and suggest that it is critical to consider cognitive demands during motor testing and neurorehabilitation after stroke.

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Brain-machine Interface in Robot-assisted Neurorehabilitation for Patients with Stroke and Upper Extremity Weakness – the Therapeutic Turning Point

Brain & Neurorehabilitation ◽

10.12786/bn.2016.9.e5 ◽

2016 ◽

Vol 9 (2) ◽

Cited By ~ 1

Author(s):

Jung Hwan Kim

Keyword(s):

Upper Extremity ◽

Turning Point ◽

Brain Machine Interface ◽

Robot Assisted ◽

Machine Interface

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Action Observation Treatment-Based Exoskeleton (AOT-EXO) for Upper Extremity After Stroke: Study Protocol for a Randomised Controlled Trial

10.21203/rs.3.rs-58170/v1 ◽

2021 ◽

Author(s):

Zejian Chen ◽

Nan Xia ◽

Chang He ◽

Minghui Gu ◽

Jiang Xu ◽

...

Keyword(s):

Upper Extremity ◽

Functional Disability ◽

Motor Evoked Potentials ◽

Action Observation ◽

Controlled Trial ◽

Measurement Unit ◽

Motor Deficit ◽

Robot Assisted ◽

Clinical Trial Registry ◽

Resting Motor Threshold

Abstract Background Stroke produces multiple symptoms, including sensory, motor, cognitive and psychological dysfunctions, among which motor deficit is the most common and is widely recognized as a major contributor to long-term functional disability. Robot-assisted training is effective in promoting upper extremity muscle strength and motor impairment recovery after stroke. Additionally, action observation treatment can enhance the effects of physical and occupational therapy by increasing neural activation. The AOT-EXO trial aims to investigate whether action observation treatment coupled with robot-assisted training could enhance motor circuit activation and improve upper extremity motor outcomes. Methods The AOT-EXO trial is a multicentre, prospective, three-group randomized controlled trial (RCT). We will screen and enrol 132 eligible patients in the trial implemented in the Department of Rehabilitation Medicine of Tongji Hospital, Optical Valley Branch of Tongji Hospital and Hubei Province Hospital of Integrated Chinese & Western Medicine in Wuhan, China. Prior to study participation, written informed consent will be obtained from eligible patients in accordance with the Declaration of Helsinki. The enrolled stroke patients will be randomised to three groups: the CT group (conventional therapy); EXO group (exoskeleton therapy) and AOT-EXO group (action observation treatment-based exoskeleton therapy). The patients will undergo blinded assessments at baseline, post-intervention (after 4 weeks) and follow-up (after 12 weeks). The primary outcome will be the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Secondary outcomes will include the Action Research Arm Test (ARAT), modified Barthel Index (MBI), kinematic metrics assessed by inertial measurement unit (IMU), resting motor threshold (rMT), motor evoked potentials (MEP), functional magnetic resonance imaging (fMRI) and safety outcomes. Discussion This trial will provide evidence regarding the feasibility and efficacy of the action observation treatment-based exoskeleton (AOT-EXO) for post-stroke upper extremity rehabilitation and elucidate the potential underlying kinematic and neurological mechanisms. Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR1900026656. Registered on 17 October 2019.

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Effects of robot-assisted therapy on upper extremity function and activities of daily living in hemiplegic patients: A single-blinded, randomized, controlled trial

Technology and Health Care ◽

10.3233/thc-181336 ◽

2018 ◽

Vol 26 (4) ◽

pp. 659-666 ◽

Cited By ~ 1

Author(s):

Min-Jae Lee ◽

Jung-Hoon Lee ◽

Sun-Min Lee

Keyword(s):

Randomized Controlled Trial ◽

Activities Of Daily Living ◽

Upper Extremity ◽

Daily Living ◽

Controlled Trial ◽

Robot Assisted ◽

Randomized Controlled ◽

Extremity Function ◽

Upper Extremity Function

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Robot-Assisted Reach Training With an Active Assistant Protocol for Long-Term Upper Extremity Impairment Poststroke: A Randomized Controlled Trial

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2018.10.002 ◽

2019 ◽

Vol 100 (2) ◽

pp. 213-219 ◽

Cited By ~ 2

Author(s):

Ki Hun Cho ◽

Won-Kyung Song

Keyword(s):

Randomized Controlled Trial ◽

Upper Extremity ◽

Controlled Trial ◽

Robot Assisted ◽

Randomized Controlled ◽

Upper Extremity Impairment

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P4: Grip strength during the first year after stroke and its relation to upper extremity motor performance and dexterity

Gait & Posture ◽

10.1016/j.gaitpost.2017.06.369 ◽

2017 ◽

Vol 57 ◽

pp. 202

Author(s):

Roland Stock ◽

Torunn Askim ◽

Gyrd Thrane ◽

Audny Anke ◽

Paul Jarle Mork

Keyword(s):

Grip Strength ◽

Upper Extremity ◽

Motor Performance ◽

First Year

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Trajectory of Motor Performance Over Twelve Months in Nigerian Stroke Survivors

Brain Impairment ◽

10.1017/brimp.2014.3 ◽

2014 ◽

Vol 15 (1) ◽

pp. 43-50 ◽

Cited By ~ 3

Author(s):

Grace Oluwatitofunmi Vincent-Onabajo ◽

Talhatu Kolapo Hamzat ◽

Mayowa Ojo Owolabi

Keyword(s):

Lower Extremity ◽

Upper Extremity ◽

Motor Performance ◽

First Year ◽

Stroke Survivors ◽

Health Institution ◽

Post Stroke ◽

Severe Impairment ◽

Upper And Lower Extremities

Objective: Submissions on recovery of post-stroke motor performance vary, especially in relation to increasing time after stroke. This study examined the trajectory of motor performance over the first 12 months after stroke.Methods: Consecutive first-incidence stroke survivors (N = 83) were recruited within 1 month of onset from a tertiary health institution in Nigeria. Simplified Fugl Meyer scale (S-FM) was used to assess motor performance at monthly intervals. Changes in overall motor performance, and differences between the affected upper and lower extremities, were examined using Friedman's ANOVA and paired t-tests, respectively.Results: Significant improvement in motor performance was observed across 12 months (p < .001), with the proportion of stroke survivors with severe impairment at onset (53.3%) decreasing to 20% by 12 months. Lower extremity motor performance scores were significantly higher than for the upper extremity from 1 to 12 months (p <.01 at 3, 4, 5, 6 and 12 months; and p < .05 at the remaining months).Conclusions: The potential for long-term improvement in motor performance after stroke was observed, suggesting that this can be harnessed by long-term rehabilitation efforts. The comparatively poorer outcome in the upper extremity indicates the need for extra rehabilitation strategies to enhance upper-extremity motor recovery in the first year of stroke.

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