The Combined Effects of Adaptive Control and Virtual Reality on Robot-Assisted Fine Hand Motion Rehabilitation in Chronic Stroke Patients: A Case Study

J Stroke Cerebrovasc Dis. 2018 Jan;27(1):221-228. doi: 10.1016/j.jstrokecerebrovasdis.2017.08.027. Epub 2017 Sep 14.

Abstract

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills. The effectiveness of the proposed system is tested by conducting clinical trials on a chronic stroke patient and verified through clinical evaluation methods by measuring the key kinematic features such as active range of motion (ROM), finger strength, and velocity. By comparing the pretraining and post-training results, the study demonstrates that the proposed method can further enhance the effectiveness of fine hand motion rehabilitation training by improving finger ROM, strength, and coordination.

Keywords: Stroke rehabilitation; assist-as-needed control; clinical assessment; rehabilitation gaming system; robot assisted therapy; virtual reality.

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Biomechanical Phenomena
  • Chronic Disease
  • Female
  • Hand / innervation*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity*
  • Muscle Strength
  • Neuronal Plasticity
  • Range of Motion, Articular
  • Recovery of Function
  • Robotics*
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Time Factors
  • Treatment Outcome
  • Video Games*
  • Virtual Reality Exposure Therapy*