Action observation treatment-based exoskeleton (AOT-EXO) for upper extremity after stroke: study protocol for a randomized controlled trial

Chen, Zejian; Xia, Nan; He, Chang; Gu, Minghui; Xu, Jiang; Han, Xiaohua; Huang, Xiaolin

doi:10.1186/s13063-021-05176-x

Cited by 4 publications

(3 citation statements)

References 37 publications

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“…Total scores range from 0 to 57. The ARAT is often used in post-stroke rehabilitation studies as a primary outcome measure [ 36 – 38 ] or secondary outcome measure [ 39 ]. As such, we have included it as an additional outcome measure.…”

Section: Interventionsmentioning

confidence: 99%

Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial

Stoykov

Biller

Wax

et al. 2022

Trials

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Background Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected limb, bimanual motor function, and interhemispheric inhibition in moderate to severely impaired people with stroke. Methods Seventy-six participants will be randomized to receive either 15, 2-h sessions, 3 times per week for 5 weeks (30 h of intervention) of bilateral motor priming and task-specific training (experimental group) or the same dose of control priming plus the task-specific training protocol. The experimental group performs bilateral symmetrical arm movements via the Exsurgo priming device which allows both wrists to move in rhythmic, symmetrical wrist flexion and extension for 15 min. The goal is one cycle (wrist flexion and wrist extension) per second. The control priming group receives transcutaneous electrical stimulation below sensory threshold for 15 min prior to the same 45 min of task-specific training. Outcome measures are collected at pre-intervention, post-intervention, and follow-up (8 weeks post-intervention). The primary outcome measure is the Fugl-Meyer Test of Upper Extremity Function. The secondary outcome is the Chedoke Arm and Hand Activity Index-Nine, an assessment of bimanual functional tasks. Discussion To date, there are only 6 studies documenting the efficacy of priming using bilateral movements, 4 of which are pilot or feasibility studies. This is the first large-scale clinical trial of bilateral priming plus task-specific training. We have previously completed a feasibility intervention study of bilateral motor priming plus task-specific training and have considerable experience using this protocol. Trial registration ClinicalTrials.gov NCT03517657. Retrospectively registered on May 7, 2018.

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Section: Interventionsmentioning

confidence: 99%

Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial

Stoykov

Biller

Wax

et al. 2022

Trials

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“…This can involve supporting the arm during movement or guiding the movement toward the target using external forces. 14 This type of robotic training mimics daily activities while minimizing the use of compensation strategies. However, this type of therapy may not maximally motivate the patients to make a sufficient effort to promote motor plasticity.…”

Section: Introductionmentioning

confidence: 99%

“…In robotic‐assisted therapy, the device helps patients complete the motor task when they are unable to do so by themselves. This can involve supporting the arm during movement or guiding the movement toward the target using external forces 14 . This type of robotic training mimics daily activities while minimizing the use of compensation strategies.…”

Section: Introductionmentioning

confidence: 99%

Robotically driven Error Augmentation training enhances post‐stroke arm motor recovery

Carmeli

Israely

Barel

et al. 2023

Engineering Reports

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Stroke is a major cause of long‐term functional disability and requires physical rehabilitation. Due to population aging, the number of people post stroke is going to rise. Robotically neurorehabilitation has a great potential to improve outcome measurements. Error Augmentation training using a robotic interface is thought to promote motor recovery by enhancing proprioceptive feedback, which motivates and challenges patients to optimize their performance during training. Here, we investigated the effectiveness of robotic Error Augmentation training on motor recovery after a stroke, compared to standard robotic training in a null field. Post‐stroke patients were randomly assigned to one of two groups: a study group (n = 9) that was trained on a 3D robotic system applying Error Augmentation forces, and a control group (n = 7) that carried out the same protocol in null field conditions. The robotic rehabilitation intervention was applied in addition to the standard rehabilitation protocol of the rehabilitation center. Error Augmentation training increased clinical scores compared to standard robotic training by 266% on the Motor Assessment Scale, and 88% on the Fugl‐Meyer scale. The Motor Assessment Scale scores were significantly correlated with the Fugl‐Meyer scores (p = 0.03, r = 0.541). There were more movement errors on the initial trials of the game sequence using the DeXtreme robotic device with Error Augmentation compared to trials with no force field. This difference vanished however after 10 trials. Error Augmentation training decreased the number of movement units and jerkiness compared to the control treatment. There was a robust effect of magnifying the acceleration component of movement using EA on the smoothness of the movement. These findings suggest that EA training may enhance motor performance possibly through motor adaptation. Future study should include EMG to better elucidate the neural mechanisms involved in motor learning post CNS injury.

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Video parameters for action observation training in stroke rehabilitation: a scoping review

Biswas

Rao

Madhavan

et al. 2023

Disability and Rehabilitation

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Action observation treatment-based exoskeleton (AOT-EXO) for upper extremity after stroke: study protocol for a randomized controlled trial

Cited by 4 publications

References 37 publications

Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial

Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial

Robotically driven Error Augmentation training enhances post‐stroke arm motor recovery

Video parameters for action observation training in stroke rehabilitation: a scoping review

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