Is cognition considered in post-stroke upper limb robot-assisted therapy trials? A brief systematic review

Everard, Gauthier; Ajana, Khawla; Dehem, Stéphanie; Stoquart, Gaëtan; Edwards, Martin; Lejeune, Thierry

doi:10.1097/mrr.0000000000000420

Cited by 13 publications

(12 citation statements)

References 22 publications

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“…Studying clinical groups can also reveal how embodied theories of language processing can help clinical treatment. In clinical practice, treatment following brain damage demonstrates the strong link between motor actions and language (e.g., Everard et al, 2020).…”

Section: From Normal Aging To Neurodegenerative Diseases and Brain Da...mentioning

confidence: 99%

Ecological meanings: A consensus paper on individual differences and contextual influences in embodied language

Ibáñez¹,

Kühne²,

Miklashevsky³

et al. 2022

Preprint

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Embodied theories of cognition consider many aspects of language and other cognitive domains as the result of sensory and motor processes. In this view, the appraisal and the use of concepts are based on mechanisms of simulation grounded on prior sensorimotor experiences. Even though these theories continue receiving attention and support, increasing evidence indicates the need to consider the flexible nature of the simulation process, and to accordingly refine embodied accounts. In this consensus paper, we discuss two potential sources of variability in experimental studies on embodiment of language: individual differences and context. Specifically, we show how factors contributing to individual differences may explain inconsistent findings in embodied language phenomena. These factors include sensorimotor or cultural experiences, imagery, context-related factors, and cognitive strategies. We also analyze the different contextual modulations, from single words to sentences and narratives, as well as the top-down and bottom-up influences. Similarly, we review recent efforts to include cultural and language diversity, aging, neurodegenerative diseases, and brain disorders, as well as bilingual evidence into the embodiment framework. We address the importance of considering individual differences and context in clinical studies to drive translational research more efficiently, and we indicate recommendations on how to correctly address these issues in future research. Systematically investigating individual differences and context may contribute to understanding the dynamic nature of simulation in language processes, refining embodied theories of cognition, and ultimately filling the gap between cognition in artificial experimental settings and cognition in the wild (i.e., in everyday life).

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Section: From Normal Aging To Neurodegenerative Diseases and Brain Da...mentioning

confidence: 99%

Ecological meanings: A consensus paper on individual differences and contextual influences in embodied language

Ibáñez¹,

Kühne²,

Miklashevsky³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Studies of rehabilitation technologies to date have typically selected high-functioning cohorts, which limits the applicability of their findings. 22 A related issue is that clinical trials of UL rehabilitation technologies typically control for exercise dosage between treatment groups, in order to test whether interventions are as effective as dose-matched, conventional therapy. [23][24][25][26][27][28] This entails researchers imposing scheduled therapy sessions, while closely supervising and supporting participants.…”

Section: Introductionmentioning

confidence: 99%

Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care

Broderick

Almedom

Burdet

et al. 2021

Neurorehabil Neural Repair

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Background. One of the strongest modifiable determinants of rehabilitation outcome is exercise dose. Technologies enabling self-directed exercise offer a pragmatic means to increase dose, but the extent to which they achieve this in unselected cohorts, under real-world constraints, is poorly understood. Objective. Here we quantify the exercise dose achieved by inpatient stroke survivors using an adapted upper limb (UL) exercise gaming (exergaming) device and compare this with conventional (supervised) therapy. Methods. Over 4 months, patients presenting with acute stroke and associated UL impairment were screened at a single stroke centre. Participants were trained in a single session and provided with the device for unsupervised use during their inpatient admission. Results. From 75 patients referred for inpatient UL therapy, we recruited 30 (40%), of whom 26 (35%) were able to use the device meaningfully with their affected UL. Over a median enrolment time of 8 days (IQR: 5–14), self-directed UL exercise duration using the device was 26 minutes per day (median; IQR: 16–31), in addition to 25 minutes daily conventional UL therapy (IQR: 12–34; same cohort plus standard care audit; joint n = 50); thereby doubling total exercise duration (51 minutes; IQR: 32–64) relative to standard care (Z = 4.0, P <.001). The device enabled 104 UL repetitions per day (IQR: 38–393), whereas conventional therapy achieved 15 UL repetitions per day (IQR: 11–23; Z = 4.3, P <.001). Conclusion. Self-directed adapted exergaming enabled participants in our stroke inpatient cohort to increase exercise duration 2-fold, and repetitions 8-fold, compared to standard care, without requiring additional professional supervision.

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“… 38 , 39 Therefore, developing serious games with cognitive components might provide be interesting for neurorehabilitation involving virtual reality or robotics. 40 …”

Section: Discussionmentioning

confidence: 99%

Evidence of Motor Skill Learning in Acute Stroke Patients Without Lesions to the Thalamus and Internal Capsule

Riga

Gathy

Ghinet

et al. 2022

Stroke

Self Cite

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Background: It is currently unknown whether motor skill learning (MSkL) with the paretic upper limb is possible during the acute phase after stroke and whether lesion localization impacts MSkL. Here, we investigated MSkL in acute (1–7 days post) stroke patients compared with healthy individuals (HIs) and in relation to voxel-based lesion symptom mapping. Methods: Twenty patients with acute stroke and 35 HIs were trained over 3 consecutive days on a neurorehabilitation robot measuring speed, accuracy, and movement smoothness variables. Patients used their paretic upper limb and HI used their nondominant upper limb on an MSkL task involving a speed/accuracy trade-off. Generalization was evaluated on day 3. All patients underwent a 3-dimensional magnetic resonance imaging used for VSLM. Results: Most patients achieved MSkL demonstrated by day-to-day retention and generalization of the newly learned skill on day 3. When comparing raw speed/accuracy trade-off values, HI achieved larger MSkL than patients. However, relative speed/accuracy trade-off values showed no significant differences in MSkL between patients and HI on day 3. In patients, MSkL progression correlated with acute motor and cognitive impairments. The voxel-based lesion symptom mapping showed that acute vascular damage to the thalamus or the posterior limb of the internal capsule reduced MSkL. Conclusions: Despite worse motor performance for acute stroke patients compared with HI, most patients were able to achieve MSkL with their paretic upper limb. Damage to the thalamus and posterior limb of the internal capsule, however, reduced MSkL. These data show that MSkL could be implemented into neurorehabilitation during the acute phase of stroke, particularly for patients without lesions to the thalamus and posterior limb of the internal capsule. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01519843.

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Is cognition considered in post-stroke upper limb robot-assisted therapy trials? A brief systematic review

Cited by 13 publications

References 22 publications

Ecological meanings: A consensus paper on individual differences and contextual influences in embodied language

Ecological meanings: A consensus paper on individual differences and contextual influences in embodied language

Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care

Evidence of Motor Skill Learning in Acute Stroke Patients Without Lesions to the Thalamus and Internal Capsule

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