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The re-education of upper limb movement post stroke using iterative learning control mediated by electrical stimulation

Hughes, Ann-Marie (2009) The re-education of upper limb movement post stroke using iterative learning control mediated by electrical stimulation University of Southampton, School of Electronics and Computer Science, Doctoral Thesis , 235pp.

Record type: Thesis (Doctoral)


An inability to perform tasks involving reaching is a common problem following
stroke. Evidence supports the use of robotic therapy and electrical stimulation (ES)
to reduce upper limb impairments following stroke, but current systems may not
encourage maximal voluntary contribution from the participant. This study developed
and tested iterative learning control (ILC) algorithms mediated by ES, using a
purpose designed robotic workstation, for upper limb rehabilitation post stroke.
Surface electromyography (EMG) which may be related to impaired performance
and function was used to investigate seven shoulder and elbow muscle activation
patterns in eight neurologically intact and five chronic stroke participants during nine
tracking tasks. The participants’ forearm was supported using a hinged arm-holder,
which constrained their hand to move in a two dimensional horizontal plane.
Outcome measures taken prior to and after an intervention consisted of the Fugl-
Meyer Assessment (FMA) and the Action Research Arm Test (ARAT), isometric
force and error tracking. The intervention for stroke participants consisted of
eighteen sessions in which a similar range of tracking tasks were performed with the
addition of responsive electrical stimulation to their triceps muscle. A question set
was developed to understand participants’ perceptions of the ILC system.
Statistically significant improvements were measured (p?0.05) in: FMA motor score,
unassisted tracking, and in isometric force. Statistically significant differences in
muscle activation patterns were observed between stroke and neurologically intact
participants for timing, amplitude and coactivation patterns. After the intervention
significant changes were observed in many of these towards neurologically intact
ranges. The robot–assisted therapy was well accepted and tolerated by the stroke
participants. This study has demonstrated the feasibility of using ILC mediated by
ES for upper limb stroke rehabilitation in the treatment of stroke patients with upper
limb hemiplegia.

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Published date: January 2009
Organisations: University of Southampton


Local EPrints ID: 66283
PURE UUID: 9c540985-d53b-4823-a98b-c5b480bad1d4
ORCID for Ann-Marie Hughes: ORCID iD
ORCID for Jane Burridge: ORCID iD

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Date deposited: 21 Jul 2009
Last modified: 19 Jul 2017 00:26

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Thesis advisor: Paul Chappell
Thesis advisor: Eric Rogers
Thesis advisor: Jane Burridge ORCID iD
Thesis advisor: Paul Lewin

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