TY - GEN
T1 - Influence of training environment and cognitive deficits on use of feedback for motor learning in chronic stroke
AU - Subramanian, Sandeep K.
AU - Chilingaryan, Gevorg
AU - Levin, Mindy F.
AU - Sveistrup, Heidi
N1 - Publisher Copyright:
© 2015 IEEE.
PY - 2015/12/16
Y1 - 2015/12/16
N2 - 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.
AB - 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.
KW - arm-motor recovery
KW - cognition
KW - kinematics
KW - knowledge of performance
KW - knowledge of results
KW - rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85014640829&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85014640829&partnerID=8YFLogxK
U2 - 10.1109/ICVR.2015.7358582
DO - 10.1109/ICVR.2015.7358582
M3 - Conference contribution
AN - SCOPUS:85014640829
T3 - International Conference on Virtual Rehabilitation, ICVR
SP - 38
EP - 43
BT - 2015 International Conference on Virtual Rehabilitation, ICVR 2015
PB - Institute of Electrical and Electronics Engineers Inc.
T2 - 11th Annual International Conference on Virtual Rehabilitation, ICVR 2015
Y2 - 9 June 2015 through 12 June 2015
ER -