Error-enhanced Learning & Recovery in 2 & 3 Dimensions
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- Arm motor recovery scores on the Fugl-Meyer
研究概览
简要总结
This study investigates the potential of customized robotic and visual feedback interaction to improve recovery of movements in stroke survivors. While therapists widely recognize that customization is critical to recovery, little is understood about how take advantage of statistical analysis tools to aid in the process of designing individualized training. Our approach first creates a model of a person's own unique movement deficits, and then creates a practice environment to correct these problems. Experiments will determine how the deficit-field approach can improve (1) reaching accuracy, (2) range of motion, and (3) activities of daily living. The findings will not only shed light on how to improve therapy for stroke survivors, it will test hypotheses about fundamental processes of practice and learning. This study will help us move closer to our long-term goal of clinically effective treatments using interactive devices.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 100 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •STROKE SURVIVORS:
- •adult (age >18)
- •Chronic stage stroke recovery (8+ months post)
- •available medical records and radiographic information about lesion locations
- •strokes caused by an ischemic infarct in the middle cerebral artery
- •primary motor cortex involvement
- •a Fugl-Meyer score (between 15-50) to evaluate arm motor impairment level
- •HEALTHY CONTROL PARTICIPANTS:
- •adult (age >18)
- •healthy individuals with no history of stroke or neural injury
排除标准
- •bilateral paresis;
- •severe sensory deficits in the limb
- •severe spasticity (Modified Ashworth of 4) preventing movement
- •aphasia, cognitive impairment or affective dysfunction that would influence the ability to perform the experiment
- •inability to provide an informed consent
- •severe current medical problems
- •diffuse/multiple lesion sites or multiple stroke events
- •hemispatial neglect or visual field cut that would prevent subjects from seeing the targets.
研究组 & 干预措施
Deficit-fields to reduce error
We hypothesize that a deficit-field design, using the statistics of a patient's errors to customize training, will provide optimal augmentation that varies during motion as needed. We will compare the training effects of error deficit-fields with previous methods of error augmentation to improve reaching ability.
干预措施: Deficit-fields to reduce error (Behavioral)
Deficit-fields to expand range of motion
Amplifying augmentation can expand motor exploration and improve skill retention in patients. Using motor exploration patterns from each patient, we will form customized deficit-fields to recover normal joint workspace. We will compare augmentation training that either amplifies or diminishes the observed deficits (Expt-1). We also compare deficit-fields with our prior augmentation methods to determine the added value of increased customization (Expt-2).
干预措施: Deficit-fields to expand range of motion (Behavioral)
Deficit-fields to improve function
Here we present visual distortion of whole body movement during manual tasks during standing, including reaching, grasping, and object manipulation. We compare the training effects of feedback based on deficit-fields versus practice with normal vision.
干预措施: Deficit-fields to improve function (Behavioral)
结局指标
主要结局
Arm motor recovery scores on the Fugl-Meyer
时间窗: Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5
Change from baseline in arm motor recovery as measured by Fugl-Meyer
次要结局
- Modified Ashworth Scale (MAS)(Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5)
- Time and completion score for Action Research Arm Test (ARAT)(Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5)
- Number of blocks transferred in Box and Blocks Test(Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5)
- Elbow active range of motion (ROM)(Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5)
- Chedoke McMaster Stroke Assessment for Hand(Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5)
研究者
James Patton
Co-Director, Robotics Laboratory, Sensory Motor Performance Program, Rehabilitation Institute of Chicago
Shirley Ryan AbilityLab