Somesthetic, Visual, and Auditory Feedback and Their Interactions Applied to Upper Limb Neurorehabilitation Technology: A Narrative Review to Facilitate Contextualization of Knowledge

Abstract

Reduced hand dexterity is a common component of sensorimotor impairments for individuals after stroke. To improve hand function, innovative rehabilitation interventions are constantly developed and tested. In this context, technology-based interventions for hand rehabilitation have been emerging rapidly. This paper offers an overview of basic knowledge on post lesion plasticity and sensorimotor integration processes in the context of augmented feedback and new rehabilitation technologies, in particular virtual reality and soft robotic gloves. We also discuss some factors to consider related to the incorporation of augmented feedback in the development of technology-based interventions in rehabilitation. This includes factors related to feedback delivery parameter design, task complexity and heterogeneity of sensory deficits in individuals affected by a stroke. In spite of the current limitations in our understanding of the mechanisms involved when using new rehabilitation technologies, the multimodal augmented feedback approach appears promising and may provide meaningful ways to optimize recovery after stroke. Moving forward, we argue that comparative studies allowing stratification of the augmented feedback delivery parameters based upon different biomarkers, lesion characteristics or impairments should be advocated (e.g., injured hemisphere, lesion location, lesion volume, sensorimotor impairments). Ultimately, we envision that treatment design should combine augmented feedback of multiple modalities, carefully adapted to the specific condition of the individuals affected by a stroke and that evolves along with recovery. This would better align with the new trend in stroke rehabilitation which challenges the popular idea of the existence of an ultimate good-for-all intervention.

The Role of Biofeedback in Patellofemoral Pain Conservative Treatment: A Systematic Review

“…These techniques give patients information during treatment to influence their neuro-motor functions. These feedback data can be distinguished into visual, auditory, and somesthetic feedback [ 4 ].…”

User-centered development process of an operating interface to couple a robotic glove with a virtual environment to optimize hand rehabilitation following a stroke

“…Robotic technologies, such as robotic gloves, present an opportunity to practice a task-specific training regime that aligns with the principles of neuroplasticity to help functional recovery after a stroke. 1 Rehabilitation outcomes following a stroke are not only impacted by whether the individual receives task-specific training, but also by the intensity of the rehabilitation. 2 When comparing higher intensity training to normal intensity of conventional rehabilitation interventions (e.g., over 2.5 times the intensity) higher intensity training shows significantly higher activity levels in subacute and chronic stroke.…”

Orchestrating Motion: Real-Time Sonification Tools and Methods to Support Movement Rehabilitation

“…Conceptual frameworks addressing movement sonification design as early as 2005 (e.g. in [67]) were built on neuroscientific theories such as ecological perception [80] and multisensory integration [216], and have evolved over time by integrating perspectives from embodied cognition [73,189] and motor learning theory [133,184]. To address the persisting lack of movement sonification design guidelines, the following first preliminary problem formulation was framed:…”

“…Stroke is a major global age-related cause of disability and death that typically causes multiple anatomical and physiological changes to the brain [184], resulting in hemiparesis / one-sided weakness of ranging severity in survivors [198]. Stroke is significantly impactful both personally and societally, with potentially devastating effects on quality of life due to reduced social contact, dependence, and home confinement [255].…”

“…It has been suggested that recovery may be improved by treating motor impairment within the framework of a motor control theory [133,147]. Given how biofeedback operates through sensorimotor interaction, it is relevant to approach it from a motor learning perspective termed as the dynamical or ecological model of motor learning, which views motor learning as a process that strengthens the relationship between perception and action, emphasizing dynamic exploratory activity of the perceptual / motor workspace to create optimal strategies for performing a task, giving rise to adaptability based on task demands and constraints [25,133,184]. This approach considers the interaction between the individual and its environment in order to determine task-relevant movement dynamics, and focuses on information that can regulate action within the perceptuomotor workspace [168].…”