Cerebrovascular Accident, Hemiparesis, Hemiplegia
Conditions
Keywords
Cerebrovascular Accident, Robotics, Virtual Reality, Rehabilitation, Neuroplasticity
Brief summary
The complexity of sensorimotor control required for hand function as well as the wide range of recovery of manipulative abilities makes rehabilitation of the hand most challenging. The investigators past work has shown that training in a virtual environment (VE) using repetitive, adaptive algorithms has the potential to be an effective rehabilitation medium to facilitate motor recovery of hand function. These findings are in accordance with current neuroscience literature in animals and motor control literature in humans. The investigators are now in a position to refine and optimize elements of the training paradigms to enhance neuroplasticity. The investigators first aim tests if and how competition among body parts for neural representations stifles functional gains from different types of training regimens. The second aim tests the functional benefits of unilateral versus bilateral training regimens.The third aim tests whether functional improvements gained from training in a virtual environment transfer to other (untrained) skills in the real world.
Detailed description
The complexity of sensorimotor control required for hand function as well as the wide range of recovery of manipulative abilities makes rehabilitation of the hand most challenging. The investigators past work has shown that training in a virtual environment (VE) using repetitive, adaptive algorithms has the potential to be an effective rehabilitation medium to facilitate motor recovery of hand function. These findings are in accordance with current neuroscience literature in animals and motor control literature in humans. The investigators are now in a position to refine and optimize elements of the training paradigms to enhance neuroplasticity. The investigators first aim tests if and how competition among body parts for neural representations stifles functional gains from different types of training regimens. The second aim tests the functional benefits of unilateral versus bilateral training regimens.The third aim tests whether functional improvements gained from training in a virtual environment transfer to other (untrained) skills in the real world.
Interventions
BEHAVIORALHAS Training
Robotically measured and facilitated training of the hemiparetic hand and arm in isolation, in a three dimensional haptically rendered virtual environment.
BEHAVIORALHAT training
Robotically measured and facilitated training of the hemiparetic hand and arm as an integrated functional unit, in a three dimensional haptically rendered virtual environment
BEHAVIORALBimanual Training
Robotically measured and facilitated training of the hemiparetic hand and non-hemiparetic hand together, in a three dimensional haptically rendered virtual environment
Sponsors
Rutgers, The State University of New Jersey
New Jersey Institute of Technology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Six months post cerebrovascular accident * Residual upper extremity impairment that affects participation * At least ten degrees of active finger extension * Tolerate passive shoulder flexion to chest level
Exclusion criteria
* Severe neglect * Severe aphasia
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in Jebsen Test of Hand Function | Two Weeks Prior to Training, Immediately Prior to Training, Immediately After Training, 3 Months After Training |
Secondary
| Measure | Time frame |
|---|---|
| Change in Wolf Motor Function Test | Two Weeks Prior to Training, Immediately Prior to Training, Immediately After Training, 3 Months After Training |
| Change in 9 Hole Peg Test | Two Weeks Prior to Training, Immediately Prior to Training, Immediately After Training, 3 Months After Training |
| Change in Box and Blocks Test | Two Weeks Prior to Training, Immediately Prior to Training, Immediately After Training, 3 Months After Training |
| Change in Robotically Collected Kinematics | 1 day before training and 1 day after training |
| Change in Reach to Grasp Test | 1 day before training and 1 day after training |
Countries
United States
Outcome results
None listed