Preliminary results for a force feedback bimanual rehabilitation system

摘要

Stroke, a cardiovascular disease, is causing an increasingly heavy financial and medical load in modern societies. Yet the current therapeutic alternatives leave many individuals with stroke with limited ability to sustain an independent lifestyle. In turn, stroke survivors' quality of life is significantly diminished. Physical therapy is considered the main course of treatment for individuals with chronic stroke. Predominantly, research in rehabilitation investigates methods aiming to maximize the treatment benefits to patients. A novel Bimanual Wearable Robotic Device (BWRD) and protocol are proposed for the rehabilitation of stroke patients. The BWRD is composed of Master and Slave devices for the non-paretic and paretic upper limbs respectively. While the non-paretic arm controls the paretic arm in position, force feedback from the paretic arm, providing an indication of impairment, is sent back to the non-paretic arm. In this preliminary study, three participants with chronic unilateral stroke were recruited to participate in a total of three sessions per participant. To evaluate the effects of the BWRD, participants underwent pre and post training functional assessments. In addition we explored the neurobiological effects of this therapy using indices of brain excitability (Transcranial Magnetic Stimulation (TMS)), brain activity (Electroencephalography (EEG)) and muscle activation (Electromyography (EMG)). This work presents preliminary results. Following bimanual training, we measured an increase in excitability of both hemispheres as well as reduced inhibition as measured by Transcallosal Inhibition Laterality Index (TCI LI). The presented data supports and validates the approach implemented with the BWRD.