Dataset Information

Motor task performance under vibratory feedback early poststroke: single center, randomized, cross-over, controlled clinical trial.

ABSTRACT: Stroke rehabilitation is far from meeting patient needs in terms of timing, intensity and quality. This study evaluates the efficacy and safety of an innovative technological tool, combining 3D motion analysis with targeted vibratory feedback, on upper-limb task performance early poststroke (<4 weeks). The study design was a two-sequence, two-period, randomized, crossover trial (NCT01967290) in 44 patients with upper-limb motor deficit (non-plegic) after medial cerebral artery ischemia. Participants were randomly assigned to receive either the experimental session (repetitive motor task under vibratory feedback and 3D motor characterization) or the active comparator (3D motor characterization only). The primary outcome was the number of correct movements per minute on a hand-to-mouth task measured independently. Vibratory feedback was able to modulate motor training, increasing the number of correct movements by an average of 7.2/min (95%CI [4.9;9.4]; P < 0.001) and reducing the probability of performing an error from 1:3 to 1:9. This strategy may improve the efficacy of training on motor re-learning processes after stroke, and its clinical relevance deserves further study in longer duration trials.

SUBMITTER: Cruz VT

PROVIDER: S-EPMC4092335 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Motor task performance under vibratory feedback early poststroke: single center, randomized, cross-over, controlled clinical trial.

Cruz Vítor Tedim VT Bento Virgílio V Ruano Luís L Ribeiro David Dieteren DD Fontão Luís L Mateus Cátia C Barreto Rui R Colunas Márcio M Alves Ana A Cruz Bárbara B Branco Catarina C Rocha Nelson P NP Coutinho Paula P

Scientific reports 20140711

Stroke rehabilitation is far from meeting patient needs in terms of timing, intensity and quality. This study evaluates the efficacy and safety of an innovative technological tool, combining 3D motion analysis with targeted vibratory feedback, on upper-limb task performance early poststroke (<4 weeks). The study design was a two-sequence, two-period, randomized, crossover trial (NCT01967290) in 44 patients with upper-limb motor deficit (non-plegic) after medial cerebral artery ischemia. Particip ...[more]

PMID: 25011667

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Project description:The central nervous system produces movements by activating specifically programmed muscle synergies that are also altered with injuries in the brain, such as stroke. In this study, we hypothesize that there exists a positive correlation between task-specific muscle synergy and motor functions at joint and task levels in patients following stroke. The purpose here is to define and evaluate neurophysiological metrics based on task-specific muscle synergy for assessing motor functions in patients. A patient group of 10 subjects suffering from stroke and a control group of nine age-matched healthy subjects were recruited to participate in this study. Electromyography (EMG) signals and movement kinematics were recorded in patients and control subjects while performing arm reaching tasks. Muscle synergies of individual patients were extracted off-line from EMG records of each patient, and a baseline pattern of muscle synergy was obtained from the pooled EMG data of all nine control subjects. Peak velocities and movement durations of each reaching movement were computed from measured kinematics. Similarity indices of matching components to those of the baseline synergy were defined by synergy vectors and time profiles, respectively, as well as by a combined similarity of vector and time profile. Results showed that pathological synergies of patients were altered from the characteristics of baseline synergy with missing components, or varied vector patterns and time profiles. The kinematic performance measured by peak velocities and movement durations was significantly poorer for the patient group than the control group. In patients, all three similarity indices were found to correlate significantly to the kinematics of movements for the reaching tasks. The correlation to the Fugl-Meyer score of arm was the highest with the vector index, the lowest with the time profile index, and in between with the combined index. These findings illustrate that the analysis of task-specific muscle synergy can provide valuable insights into motor deficits for patients following stroke, and the task-specific similarity indices are useful neurophysiological metrics to predict the function of neuromuscular control at the joint and task levels for patients.

Project description:The influence of feedback on performance is a topic of ongoing debate, with some previous studies finding it to be ineffective, while others have discovered that it can be helpful or harmful. One possible reason for these inconsistent results may be that feedback can create a conflict between a person's beliefs and the sensory information they receive. In the present study, we used a Vernier discrimination task to examine the influence of biased feedback on performance, as this type of feedback is most likely to create conflict. Biased feedback refers to feedback that does not align with the subjects' choices. The Vernier discrimination task is a type of psychophysical task that is often used to measure an individual's ability to perceive differences in the position or orientation of two visual stimuli. The task involves presenting two stimuli, one of which is slightly offset from the other, and asking the individual to determine the direction and magnitude of the offset. In Experiment 1, feedback was provided after each trial using large-offset verniers as guidance. The large-offset verniers always received correct feedback, but the small and medium-offset verniers might receive biased feedback. In Experiment 2, feedback was provided after each block of eight verniers. In Experiment 3, we removed the large offset vernier to investigate the influence of block feedback on the signal and noise. The results showed that the accuracy for the target vernier decreased due to biased feedback in both the trial feedback (Experiment 1) and the block feedback (Experiment 2). However, in Experiments 1 and 2, performance improved when feedback was absent. Moreover, if the difference between the two types of stimuli is great, the individual will engage in encoding learning rather than decision learning (Experiments 1 and 2). If the discrimination between the two types of stimuli is low, an individual's ability to discriminate noise is more vulnerable to the influence of biased feedback than the ability to discriminate the signal (Experiment 3). These results are discussed in relation to the mechanism of biased feedback, the process of encoding learning, the monitoring of internal feedback, and the generalization of false decisions.

Dataset Information

Motor task performance under vibratory feedback early poststroke: single center, randomized, cross-over, controlled clinical trial.

Publications

Motor task performance under vibratory feedback early poststroke: single center, randomized, cross-over, controlled clinical trial.

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