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Bimanual motor skill learning and robotic assistance for chronic hemiparetic stroke: a randomized controlled trial

摘要Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor skill learning (biMSkL) more than training under the active mode in stroke patients. Twenty-six healthy individuals (HI) and 23 chronic hemiparetic stroke patients with a detectable lesion on MRI or CT scan, who demonstrated motor deficits in the upper limb, were randomly allocated to two parallel groups. The protocol included a two-day training on a new bimanual cooperative task, LIFT-THE-TRAY, under either the active or active-assisted modes (where assistance decreased in a pre-determined stepwise fashion) with the bimanual version of the REAplan? robotic device. The hypothesis was that the active-assisted mode would result in greater biMSkL than the active mode. The biMSkL was quantified by a speed-accuracy trade-off (SAT) before (T1) and immediately after (T2) training on days 1 and 2 (T3 and T4). The change in SAT after 2 days of training (T4/T1) indicated that both HI and stroke patients learned and retained the bimanual cooperative task. After 2 days of training, the active-assisted mode did not improve biMSkL more than the active mode (T4/T1) in HI nor stroke patients. Whereas HI generalized the learned bimanual skill to different execution speeds in both the active and active-assisted subgroups, the stroke patients generalized the learned skill only in the active subgroup. Taken together, the active-assisted mode, applied in a pre-determined stepwise decreasing fashion, did not improve biMSkL more than the active mode in HI and stroke subjects. Stroke subjects might benefit more from robotic assistance when applied "as-needed." This study was approved by the local ethical committee (Comité d'éthique médicale, CHU UCL Namur, Mont-Godinne, Yvoir, Belgium; Internal number: 54/2010, EudraCT number: NUB B039201317382) on July 14, 2016 and was registered with ClinicalTrials.gov (Identifier: NCT03974750) on June 5, 2019.

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作者 Maral Yeganeh Doost [1] Beno?t Herman [2] Adrien Denis [3] Julien Sapin [4] Daniel Galinski [4] Audrey Riga [1] Patrice Laloux [5] Beno?t Bihin [6] Yves Vandermeeren [1] 学术成果认领
作者单位 UCLouvain, CHU UCL Namur – site Mont-Godinne, Department of Neurology, Stroke Unit, Yvoir, Belgium;UCLouvain, Institute of NeuroScience (IoNS), Clinical neuroscience division (NEUR) division, Brussels, Belgium;UCLouvain, Louvain Bionics, Louvain-la-Neuve, Belgium [1] UCLouvain, Louvain Bionics, Louvain-la-Neuve, Belgium;UCLouvain, Institute of Mechanics, Materials and Civil Engineering (iMMC), Louvain-la-Neuve, Belgium [2] UCLouvain, Institute of Mechanics, Materials and Civil Engineering (iMMC), Louvain-la-Neuve, Belgium [3] AXINESIS SA, Wavre, Belgique [4] UCLouvain, CHU UCL Namur – site Mont-Godinne, Department of Neurology, Stroke Unit, Yvoir, Belgium;UCLouvain, Institute of NeuroScience (IoNS), Clinical neuroscience division (NEUR) division, Brussels, Belgium [5] Scientific Support Unit, CHU UCL Namur – site Mont-Godinne, Yvoir, Belgium [6]
分类号 No.R493R741
栏目名称 Brain Injury and Neural Regeneration
发布时间 2021-01-08
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中国神经再生研究(英文版)

中国神经再生研究(英文版)

2021年16卷8期

1566-1573页

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