Influence of training environment and cognitive deficits on use of feedback for motor learning in chronic stroke

Sandeep K. Subramanian, Gevorg Chilingaryan, Mindy F. Levin, Heidi Sveistrup

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Scopus citations

Abstract

Feedback provision is an essential component of motor learning for improving upper limb recovery in people with stroke. Along with sensorimotor impairments, many individuals post-stroke have cognitive deficits that can influence arm motor recovery. However, few studies have identified whether the training environment and presence of cognitive deficits influences the ability to use feedback in individuals post-stroke. We evaluated the influence of the training environment and cognitive impairments on the ability to use feedback to enhance arm motor recovery. Twenty-four subjects with chronic post-stroke upper limb hemiparesis were randomized to practice pointing movements in a 3D virtual environment (VE) or a similarly designed physical environment (PE; n=12/group) for 12 sessions (72 trials/session, 3 days/week). All participants were provided with feedback about movement speed (Knowledge of Results) and trunk displacement (Knowledge of Performance). Neurocognitive functioning was assessed only before task practice (PRE), while kinematic assessments were carried out at PRE, immediately after (POST) and 3 months (RET) after task practice. Repeated measures ANOVAs with mixed models assessed the changes in kinematic outcomes. Neurocognitive function was correlated with kinematic outcomes. Those training in the VE had greater endpoint speed and ranges of shoulder horizontal adduction, shoulder flexion and elbow extension. They also tended to use less trunk displacement. Kinematic deficits influenced the ability to use feedback in people with chronic stroke for upper limb motor learning and recovery. Information about the presence of these deficits can help in the selection of the most appropriate interventions for maximizing arm motor recovery and motor learning in chronic stroke.

Original languageEnglish (US)
Title of host publication2015 International Conference on Virtual Rehabilitation, ICVR 2015
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages38-43
Number of pages6
ISBN (Electronic)9781479989843
DOIs
StatePublished - Dec 16 2015
Event11th Annual International Conference on Virtual Rehabilitation, ICVR 2015 - Valencia, Spain
Duration: Jun 9 2015Jun 12 2015

Publication series

NameInternational Conference on Virtual Rehabilitation, ICVR
ISSN (Electronic)2331-9569

Conference

Conference11th Annual International Conference on Virtual Rehabilitation, ICVR 2015
CountrySpain
CityValencia
Period6/9/156/12/15

Keywords

  • arm-motor recovery
  • cognition
  • kinematics
  • knowledge of performance
  • knowledge of results
  • rehabilitation

ASJC Scopus subject areas

  • Electrical and Electronic Engineering
  • Computer Networks and Communications

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