Effects of robot-assisted task-oriented upper limb motor training on neuroplasticity in stroke patients with different degrees of motor dysfunction: A neuroimaging motor evaluation index

Abstract

Introduction: Although robot-assisted task-oriented upper limb (UL) motor training had been shown to be e ective for UL functional rehabilitation after stroke, it did not improve UL motor function more than conventional therapy. Due to the lack of evaluation of neurological indicators, it was di cult to confirm the robot treatment parameters and clinical e cacy in a timely manner. This study aimed to explore the changes in neuroplasticity induced by robot-assisted task-oriented UL motor training in di erent degrees of dysfunction patients and extract neurological evaluation indicators to provide the robot with additional parameter information.Materials and methods: A total of adult patients with hemiplegic motor impairment after stroke were recruited as participants in this study, and a manual muscle test divided patients into muscle strength -level (severe group, n = ), -level (moderate group, n = ), and or above level (mild group, n = ). Tissue concentration of oxyhemoglobin and deoxyhemoglobin oscillations in the bilateral prefrontal cortex, dorsolateral prefrontal cortex (DLPFC), superior frontal cortex (SFC), premotor cortex, primary motor cortex (M ), primary somatosensory cortex (S ), and occipital cortex were measured by functional near-infrared spectroscopy (fNIRS) in resting and motor training state. The phase information of a .− . Hz signal was identified by the wavelet transform method. The wavelet amplitude, lateralization index, and wavelet phase coherence (WPCO) were calculated to describe the frequency-specific cortical changes. Results: Compared with the resting state, significant increased cortical activation was observed in ipsilesional SFC in the mild group and bilateral SFC in the moderate group during UL motor training. Patients in the mild Frontiers in Neuroscience frontiersin.org Xie et al. . /fnins. . group demonstrated significantly decreased lateralization of activation in motor training than resting state. Moreover, the WPCO value of motor training between contralesional DLPFC and ipsilesional SFC, bilateral SFC, contralesional, S , and ipsilesional M showed a significant decrease compared with the resting state in the mild group. Conclusion: Robot-assisted task-oriented UL motor training could modify the neuroplasticity of SFC and contribute to control movements and continuous learning motor regularity for patients. fNIRS could provide a variety of real-time sensitive neural evaluation indicators for the robot, which was beneficial to formulating more reasonable and e ective personalized prescriptions during motor training.

Upper limb motor assessment for stroke with force, muscle activation and interhemispheric balance indices based on sEMG and fNIRS

“…This result is consistent with many longitudinal studies, where the LI in stroke patients tends to increase initially after stroke, then decrease around two months to three months ( 7 ), with some studies showing a significant average decrease in LI at approximately one week after stroke, followed by an increase after three to six months ( 44 ). Some studies have not found enough significant difference in LI ( 11 , 45 ). Similar patterns have been observed for motor evoked potentials (MEPs) and sEMG ( 46 , 47 ).…”

“…The fNIRS offers advantages such as non-invasiveness, mobility, resistance to motion and electromagnetic interference, high spatial resolution, and the ability to facilitate long-term monitoring, making it conducive to researching changes in cerebral hemodynamics during muscle contraction tasks ( 7 , 10 ). fNIRS is also increasingly used to assess motor function or motor rehabilitation training effects ( 2 , 11 ). Upper limb motor is the result of the coordination of the nervous system with the corresponding muscles.…”

Effects of training with a rehabilitation device (Rebless®) on upper limb function in patients with chronic stroke: A randomized controlled trial

“…Several studies have utilized fNIRS to compare cortical activity before and after upper limb training with robotic devices in patients who have experienced a stroke. [11][12][13][14][15] One study conducted robot-assisted therapy in stroke patients with hemiplegia, using fNIRS to compare cortical activity between groups with severe and moderate impairments. [13] However, to the best of our knowledge, few studies are using fNIRS to compare cortical activity after training with a robotic device and conventional device for upper limb rehabilitation in patients with stroke.…”

“…[10] Several studies have utilized fNIRS to compare cortical activity before and after upper limb training with robotic devices in patients with stroke. [11][12][13][14][15] However, there is a particular paucity of research comparing the effects of robotic versus conventional devices on cortical activity during upper limb rehabilitation in patients with stroke.…”

Upper limb intelligent feedback robot training significantly activates the cerebral cortex and promotes the functional connectivity of the cerebral cortex in patients with stroke: A functional near-infrared spectroscopy study

“…The fNIRS has the advantages of a relatively low price, high time resolution, suitable for more places, and less noise interference. At present, fNIRS is mainly used to observe the changes in cortical activation in subjects under different conditions and after treatment, which strengthens the study of cerebral activity and reveals the principle of cortical remodeling ( 19 ). For example, the fNIRS showed that the asymmetry of sensorimotor cortex activation was significantly improved after 2 months of in-hospital rehabilitation, and the ipsilesional premotor cortex activation increased, suggesting that the motor recovery after stroke may be related to the improvement of sensorimotor cortex (SMC) activation asymmetry and the enhancement of ipsilesional premotor cortex activation ( 15 ).…”