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Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients
BACKGROUND: Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical fo...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512515/ https://www.ncbi.nlm.nih.gov/pubmed/22571177 http://dx.doi.org/10.1186/1743-0003-9-26 |
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author | Hsu, Hsiu-Yun Lin, Cheng-Feng Su, Fong-Chin Kuo, Huan-Ting Chiu, Haw-Yen Kuo, Li-Chieh |
author_facet | Hsu, Hsiu-Yun Lin, Cheng-Feng Su, Fong-Chin Kuo, Huan-Ting Chiu, Haw-Yen Kuo, Li-Chieh |
author_sort | Hsu, Hsiu-Yun |
collection | PubMed |
description | BACKGROUND: Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB) prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. METHODS: The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6–60 months) were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. RESULTS: The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033) in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005) than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009) than the hands of healthy subjects were. Training with the biofeedback system produced significant improvements in grip force modulation (p = 0.020) and better performances in the subtests of pin insertion (p = 0.019), and lifting of lightweight objects (p = 0.005). CONCLUSIONS: The CERB prototype can provide momentary and interactive information for quantitative assessing and re-educating force modulation appropriately for stroke patients with sensory deficits. Furthermore, the patients could transfer the learned strategy to improve hand function. |
format | Online Article Text |
id | pubmed-3512515 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35125152012-12-04 Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients Hsu, Hsiu-Yun Lin, Cheng-Feng Su, Fong-Chin Kuo, Huan-Ting Chiu, Haw-Yen Kuo, Li-Chieh J Neuroeng Rehabil Research BACKGROUND: Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB) prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. METHODS: The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6–60 months) were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. RESULTS: The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033) in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005) than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009) than the hands of healthy subjects were. Training with the biofeedback system produced significant improvements in grip force modulation (p = 0.020) and better performances in the subtests of pin insertion (p = 0.019), and lifting of lightweight objects (p = 0.005). CONCLUSIONS: The CERB prototype can provide momentary and interactive information for quantitative assessing and re-educating force modulation appropriately for stroke patients with sensory deficits. Furthermore, the patients could transfer the learned strategy to improve hand function. BioMed Central 2012-05-09 /pmc/articles/PMC3512515/ /pubmed/22571177 http://dx.doi.org/10.1186/1743-0003-9-26 Text en Copyright ©2012 Hsu et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Hsu, Hsiu-Yun Lin, Cheng-Feng Su, Fong-Chin Kuo, Huan-Ting Chiu, Haw-Yen Kuo, Li-Chieh Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
title | Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
title_full | Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
title_fullStr | Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
title_full_unstemmed | Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
title_short | Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
title_sort | clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512515/ https://www.ncbi.nlm.nih.gov/pubmed/22571177 http://dx.doi.org/10.1186/1743-0003-9-26 |
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