Upper limb functional impairment is one of the major limiting factors that greatly affect independent daily living of stroke survivors. Various treatments in stroke rehabilitation developed in the past have focused on motor recovery of the hemiparetic upper limb. Less effort has been made to promote the recovery of the sensory system. Sensory deficit in the upper limb results in impairment in dexterity and multi-segmental coordination. Evidences have been accumulated in the last two decades that reorganization of central nervous system may determine the progress of recovery of sensorimotor function for stroke patients. The sensory inputs during motor training could be an important triggering signal that evokes and promotes the reorganization of the central nervous system. Due to sensory deficit, many stroke patients can't perceive the cutaneous sensory inputs through direct contact with the environment during motor training and/or daily activity. They may lose an important driving force for the motor functional recovery. The goal of the proposed study is to develop a novel sensory-enhanced training technique to facilitate sensory function with motor training for stroke rehabilitation. The effectiveness of the sensory-enhanced motor training program for the recovery of sensorimotor function of the hemiparetic upper limb in a group of chronic stroke patients will be assessed in comparison to a control group. Subjects in the study group will participate in a motor training program for the hemiparetic upper limb with enhanced cutaneous sensory inputs during the training with two days in a week for a total of eight weeks. Subjects in the control group will be trained in the same motor tasks for the same amount of training time but without enhanced sensory inputs. The subjects in both the study and control groups will be tested in a baseline evaluation and an evaluation immediately after the training. The subject evaluation will include observational upper limb motor test, quantitative sensory and motor measurements, and subjective questionnaire regarding the use of the hemiparetic upper in daily functional activities. The effect of enhanced sensory inputs will be determined through the comparison of outcomes of the two training programs.
| Liu, W; Mukherjee, M; Tsaur, Y et al. (2009) Development and feasibility study of a sensory-enhanced robot-aided motor training in stroke rehabilitation. Conf Proc IEEE Eng Med Biol Soc 2009:5965-8 |
