Effects of robot viscous forces on arm movements in chronic stroke survivors: a randomized crossover study
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RESEARCH
Effects of robot viscous forces on arm movements in chronic stroke survivors: a randomized crossover study Yazan Abdel Majeed1,3† , Saria Awadalla2† and James L. Patton1,3*†
Abstract Background: Our previous work showed that speed is linked to the ability to recover in chronic stroke survivors. Participants moving faster on the first day of a 3-week study had greater improvements on the Wolf Motor Function Test. Methods: We examined the effects of three candidate speed-modifying fields in a crossover design: negative viscosity, positive viscosity, and a “breakthrough” force that vanishes after speed exceeds an individualized threshold. Results: Negative viscosity resulted in a significant speed increase when it was on. No lasting after effects on movement speed were observed from any of these treatments, however, training with negative viscosity led to significant improvements in movement accuracy and smoothness. Conclusions: Our results suggest that negative viscosity could be used as a treatment to augment the training process while still allowing participants to make their own volitional motions in practice. Trial registration: This study was approved by the Institutional Review Boards at Northwestern University (STU00206579) and the University of Illinois at Chicago (2018-1251). Keywords: Stroke, Reaching, Speed, Viscosity, Crossover Background Stroke neurorehabilitation often uses the unique aspects of technology to improve motor recovery. While some researchers endeavored to simply assist movement to more closely resemble healthy patterns [1–3], others have attempted to exploit unique capabilities of robotics or graphic feedback to encourage neuroplasticity by augmenting error [4–8]. Even some traditional physical therapy exercises use mirrors to get the paretic side of the body to imitate the non-paretic side [9]. These are beneficial but far from a complete cure, and it remains to be *Correspondence: [email protected] † Yazan Abdel Majeed, Saria Awadalla and James L. Patton contributed equally to this work 1 Richard and Loan Hill Bioengineering Department, University of Illinois at Chicago, Morgan St, 60607 Chicago, USA Full list of author information is available at the end of the article
seen what strategies emerge as optimal and what might still be left undiscovered. An alternative strategy is to first uncover the attributes associated with better clinical movement outcomes, and then target training around these [10, 11]. Our previous work [12] employed a data-driven approach to model participant improvement using metrics derived from the movements themselves. We found that participant movement speed during the initial evaluation was most predictive of clinical changes. This speed was also the most strongly correlated with changes in the Wolf Motor Function Test (WMFT), making heightened speed a possible intervention for stroke. However, before such an intervention might be tested in clinical trials, we need to establish effective methods for speeding up participants. There ar
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