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Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke
Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283673/ https://www.ncbi.nlm.nih.gov/pubmed/25601833 http://dx.doi.org/10.3389/fnhum.2014.01037 |
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author | De Santis, Dalia Zenzeri, Jacopo Casadio, Maura Masia, Lorenzo Riva, Assunta Morasso, Pietro Squeri, Valentina |
author_facet | De Santis, Dalia Zenzeri, Jacopo Casadio, Maura Masia, Lorenzo Riva, Assunta Morasso, Pietro Squeri, Valentina |
author_sort | De Santis, Dalia |
collection | PubMed |
description | Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject’s kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time. |
format | Online Article Text |
id | pubmed-4283673 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-42836732015-01-19 Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke De Santis, Dalia Zenzeri, Jacopo Casadio, Maura Masia, Lorenzo Riva, Assunta Morasso, Pietro Squeri, Valentina Front Hum Neurosci Neuroscience Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject’s kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time. Frontiers Media S.A. 2015-01-05 /pmc/articles/PMC4283673/ /pubmed/25601833 http://dx.doi.org/10.3389/fnhum.2014.01037 Text en Copyright © 2015 De Santis, Zenzeri, Casadio, Masia, Riva, Morasso and Squeri. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience De Santis, Dalia Zenzeri, Jacopo Casadio, Maura Masia, Lorenzo Riva, Assunta Morasso, Pietro Squeri, Valentina Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke |
title | Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke |
title_full | Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke |
title_fullStr | Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke |
title_full_unstemmed | Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke |
title_short | Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke |
title_sort | robot-assisted training of the kinesthetic sense: enhancing proprioception after stroke |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283673/ https://www.ncbi.nlm.nih.gov/pubmed/25601833 http://dx.doi.org/10.3389/fnhum.2014.01037 |
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