Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 4, 2011
   Pages 299 — 316

Abstract —  Retraining of interjoint arm coordination after stroke using robot-assisted time-independent functional training

Elizabeth B. Brokaw, MS;1-2 Theresa Murray, BS;1-2 Tobias Nef, PhD;3 Peter S. Lum, PhD1-2,4*

1Center for Applied Biomechanics and Rehabilitation Research, National Rehabilitation Hospital, Washington, DC; 2Department of Biomedical Engineering, The Catholic University of America, Washington, DC; 3Gerontechnology and Rehabilitation Group, Artificial Organs Center for Biomedical Engineering Research, Universit??t Bern, Bern, Switzerland; 4Washington DC Department of Veterans Affairs Medical Center, Washington, DC

Abstract — We have developed a haptic-based approach for retraining of interjoint coordination following stroke called time-independent functional training (TIFT) and implemented this mode in the ARMin III robotic exoskeleton. The ARMin III robot was developed by Drs. Robert Riener and Tobias Nef at the Swiss Federal Institute of Technology Zurich (Eidgenossische Technische Hochschule Zurich, or ETH Zurich), in Zurich, Switzerland. In the TIFT mode, the robot maintains arm movements within the proper kinematic trajectory via haptic walls at each joint. These arm movements focus training of interjoint coordination with highly intuitive real-time feedback of perform-ance; arm movements advance within the trajectory only if their movement coordination is correct. In initial testing, 37 nondisabled subjects received a single session of learning of a complex pattern. Subjects were randomized to TIFT or visual demonstration or moved along with the robot as it moved though the pattern (time-dependent [TD] training). We examined visual demonstration to separate the effects of action observation on motor learning from the effects of the two haptic guidance methods. During these training trials, TIFT subjects reduced error and interaction forces between the robot and arm, while TD subject performance did not change. All groups showed significant learning of the trajectory during unassisted recall trials, but we observed no difference in learning between groups, possibly because this learning task is dominated by vision. Further testing in stroke populations is warranted.

Key words: arm, coordination, haptics, motor control, motor learning, robotics, stroke, synergies, therapy, upper limb.

View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 4
This article and any supplementary material should be cited as follows:
Brokaw EB, Murray T, Nef T, Lum PS. Retraining of interjoint arm coordination after stroke using robot-assisted time-independent functional training. J Rehabil Res Dev. 2011;48(4):299-316.

Last Reviewed or Updated  Friday, May 13, 2011 9:41 AMCrossref

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