Stroke Rehabilitation using Learning Control Mediated by Electrical Stimulation

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Description/Abstract

Many people have problems with using their arm after a stroke, which can affect their ability to perform activities like reaching out to pick an object up. Over the last few years new technologies which use robots and electrical stimulation (ES) of muscles have been used to help with these problems. We have developed a new system which employs both of these technologies in conjunction with a technique called “Iterative Learning Control” (ILC) to help people recover movement in their arm. The aim of this study was to investigate whether ILC mediated by ES is a plausible intervention in upper limb stroke rehabilitation. Five hemiparetic participants with reduced upper limb function were asked to move their arm to track a slowing moving dot of light. This was for planar motion, replicating reaching out to an object across a table top. The participants’ arm was supported by the robot and ES was applied to the triceps brachii muscle. During each training task, the same tracking movement was repeated 6 times. After each repetition, ILC was used to compute the amount of stimulation (amplitude and timing) to be applied to the muscle on the next trial by incorporating data from previous trials of the task. Participants undertook 18 or 25, 1hour treatment sessions composed of training tasks varying in length, orientation and speed. Unassisted tracking (no ES supplied) was undertaken pre and post each treatment session. The Action Research Arm Test and the Fugl-Meyer Assessment (FMA) test were administered pre and post all treatment sessions. Significant improvements were found in 3 of 4 unassisted tracking tasks. FMA results also showed an improvement (although this was not clinically relevant). Thus, this study has shown feasibility in using ILC mediated ES for upper limb rehabilitation.