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Feasibility of iterative learning control mediated by functional electrical stimulation for reaching after stroke

Feasibility of iterative learning control mediated by functional electrical stimulation for reaching after stroke
Feasibility of iterative learning control mediated by functional electrical stimulation for reaching after stroke
BACKGROUND: An inability to perform tasks involving reaching is a common problem following stroke. Evidence supports the use of robotic therapy and functional electrical stimulation (FES) to reduce upper limb impairments, but current systems may not encourage maximal voluntary contribution from the participant because assistance is not responsive to performance.

OBJECTIVE: This study aimed to investigate whether iterative learning control (ILC) mediated by FES is a feasible intervention in upper limb stroke rehabilitation. METHODS: Five hemiparetic participants with reduced upper limb function who were at least 6 months poststroke were recruited from the community. No participants withdrew. INTERVENTION: Participants undertook supported tracking tasks using 27 different trajectories augmented by responsive FES to their triceps brachii muscle, with their hand movement constrained in a 2-dimensional plane by a robot. Eighteen 1-hour treatment sessions were used with 2 participants receiving an additional 7 treatment sessions.

OUTCOME MEASURES: The primary functional outcome measure was the Action Research Arm Test (ARAT). Impairment measures included the upper limb Fugl-Meyer Assessment (FMA), tests of motor control (tracking accuracy), and isometric force.

RESULTS: Compliance was excellent and there were no adverse events. Statistically significant improvements were measured (P <or= .05) in FMA motor score, unassisted tracking for 3 out of 4 trajectories, and in isometric force over 5 out of 6 directions. Changes in ARAT were not statistically significant.

CONCLUSION: This study has demonstrated the feasibility of using ILC mediated by FES for upper limb stroke rehabilitation.

functional electrical stimulation, stroke rehabilitation, arm movement, robotic therapy, iterative learning control, hemiplegia
1545-9683
559-568
Hughes, A.M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Freeman, C.T.
ccdd1272-cdc7-43fb-a1bb-b1ef0bdf5815
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Chappell, P.H.
2d2ec52b-e5d0-4c36-ac20-0a86589a880e
Lewin, P.L.
78b4fc49-1cb3-4db9-ba90-3ae70c0f639e
Rogers, E.
611b1de0-c505-472e-a03f-c5294c63bb72
Hughes, A.M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Freeman, C.T.
ccdd1272-cdc7-43fb-a1bb-b1ef0bdf5815
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Chappell, P.H.
2d2ec52b-e5d0-4c36-ac20-0a86589a880e
Lewin, P.L.
78b4fc49-1cb3-4db9-ba90-3ae70c0f639e
Rogers, E.
611b1de0-c505-472e-a03f-c5294c63bb72

Hughes, A.M., Freeman, C.T., Burridge, J.H., Chappell, P.H., Lewin, P.L. and Rogers, E. (2009) Feasibility of iterative learning control mediated by functional electrical stimulation for reaching after stroke. Neurorehabilitation and Neural Repair, 23 (6), 559-568. (doi:10.1177/1545968308328718).

Record type: Article

Abstract

BACKGROUND: An inability to perform tasks involving reaching is a common problem following stroke. Evidence supports the use of robotic therapy and functional electrical stimulation (FES) to reduce upper limb impairments, but current systems may not encourage maximal voluntary contribution from the participant because assistance is not responsive to performance.

OBJECTIVE: This study aimed to investigate whether iterative learning control (ILC) mediated by FES is a feasible intervention in upper limb stroke rehabilitation. METHODS: Five hemiparetic participants with reduced upper limb function who were at least 6 months poststroke were recruited from the community. No participants withdrew. INTERVENTION: Participants undertook supported tracking tasks using 27 different trajectories augmented by responsive FES to their triceps brachii muscle, with their hand movement constrained in a 2-dimensional plane by a robot. Eighteen 1-hour treatment sessions were used with 2 participants receiving an additional 7 treatment sessions.

OUTCOME MEASURES: The primary functional outcome measure was the Action Research Arm Test (ARAT). Impairment measures included the upper limb Fugl-Meyer Assessment (FMA), tests of motor control (tracking accuracy), and isometric force.

RESULTS: Compliance was excellent and there were no adverse events. Statistically significant improvements were measured (P <or= .05) in FMA motor score, unassisted tracking for 3 out of 4 trajectories, and in isometric force over 5 out of 6 directions. Changes in ARAT were not statistically significant.

CONCLUSION: This study has demonstrated the feasibility of using ILC mediated by FES for upper limb stroke rehabilitation.

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More information

e-pub ahead of print date: 3 February 2009
Published date: July 2009
Keywords: functional electrical stimulation, stroke rehabilitation, arm movement, robotic therapy, iterative learning control, hemiplegia
Organisations: Electronics & Computer Science, Health Sciences

Identifiers

Local EPrints ID: 67224
URI: http://eprints.soton.ac.uk/id/eprint/67224
ISSN: 1545-9683
PURE UUID: 8e207cce-0ae1-4b1d-a3ca-e1ba821ecd5d
ORCID for A.M. Hughes: ORCID iD orcid.org/0000-0002-3958-8206
ORCID for J.H. Burridge: ORCID iD orcid.org/0000-0003-3497-6725
ORCID for P.L. Lewin: ORCID iD orcid.org/0000-0002-3299-2556
ORCID for E. Rogers: ORCID iD orcid.org/0000-0003-0179-9398

Catalogue record

Date deposited: 12 Aug 2009
Last modified: 14 Mar 2024 02:51

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Contributors

Author: A.M. Hughes ORCID iD
Author: C.T. Freeman
Author: J.H. Burridge ORCID iD
Author: P.H. Chappell
Author: P.L. Lewin ORCID iD
Author: E. Rogers ORCID iD

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