Understanding Stroke Rehabilitation Progression in a Robotic Rehabilitation Trial
Date
2020-05-29
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Stroke is one of the leading causes of adult disability worldwide, leaving many individuals requiring rehabilitation to regain independence. A critical component to any rehabilitation program is progression, which is the ability of therapy program to change according to patient improvement. Currently, there is little known about therapy progression, which negatively impacts the optimization of rehabilitation programs. Therefore, the purpose of this thesis was to better understand how stroke survivor’s kinematics change throughout therapy in order to inform future rehabilitation programs. The first step in answering this question was to understand how motor learning contributes to recovery after stroke, which is explored in Chapter Two. Next, a therapy program was needed in order to study how stroke survivors progress during rehabilitation. The motor learning and stroke recovery principles discussed in Chapter Two were then used to inform the development of tasks for a robotic rehabilitation program for stroke survivors. The development, and subsequent testing, of the tasks are discussed in Chapter Three. It was found that this robotic therapy program was feasible after stroke and has the potential to improve clinical outcomes when compared only to standard of care. Using the results from this pilot study, the robotic therapy tasks were refined, as well as the study protocol, and gave rise to a Phase II Clinical Trial (RESTORE). As discussed in Chapter Four, subacute stroke patients were recruited to receive 20 days of robotic therapy for 1 or 2-hours a day, beginning either 5-9 days or 21-25 days post-stroke. Following completion of the intervention, changes in the participants’ kinematics measuring speed, accuracy, and smoothness of movements were examined. It was found that kinematics of directional error and hand path ratio (measures of accuracy), as well as smoothness, predominantly increased during the first 5 days of the intervention. Movement speed and percent time in target (a measure of accuracy), on the other hand, continued to improve throughout the intervention. These findings should be interpreted with caution due to small sample size but may be used to inform the progression of future robotic rehabilitation tasks.
Description
Keywords
Stroke, Stroke Recovery, Robotics
Citation
Keeling, A. B. (2020). Understanding Stroke Rehabilitation Progression in a Robotic Rehabilitation Trial (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.