Manual Dexterity, Sensory Integration Dysfunction, Stroke, Upper Extremity Paresis, Vibration; Disorder
Conditions
Brief summary
The aim of this comparative and reliability study is to highlight a deficit in the use of vibrotactile sensory feedback (haptic effect) in the planning and execution of fine manual dexterity movements after stroke. The investigators will include 3 groups of subjects, 1 group of young healthy subjects, 1 of older subjects matched in age and sex to the group of chronic stroke patients. Participants will take part in clinical tests of fine motor skills and sensitivity and will use a device to assess the key components of manual dexterity, to which vibrotactile sensors will be added. If they so wish, participants will be able to take part in a transcranial magnetic stimulation (TMS) study to assess the facilitation of cortical excitability due to the haptic effect.
Detailed description
Firstly, the investigators would like to carry out a study into the validity of measuring haptic deficits using vibro-tactile sensors positioned on the hands of chronic stroke patients and young and elderly healthy subjects. They believe that identifying the haptic deficit using a simple and rapid method, in combination with motor training, could make it possible to improve the prediction of recovery and personalise the rehabilitation of manual dexterity deficits after stroke. They will also compare the effect of tactile feedback with that of auditory feedback in order to study the specificity of the effect of this feedback on manual dexterity. In the second part, to better understand this and to study the cortical mechanisms involved in sensory-motor integration, the investigators propose to measure the haptic effect on cortical excitability in stroke patients and healthy subjects using Transcranial Magnetic Stimulation (TMS).
Interventions
DEVICEDextrain Manipulandum and haptic feedback device
Assessment of key components of manual dexterity in addition to vibrotactile stimulation on the fingers and wrist.
Sponsors
Paris Brain Institute (ICM)
Centre Hospitalier Régional d'Orléans
Centre Hospitalier St Anne
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
for healthy controls: * between 18 and 40 years old * or age and sex match with chronic stroke patients * Ability to perform motor, cognitive (MOCA score ≥26/30) and sensory assessment Inclusion Criteria for chronic stroke patients: * More than 18 years old * Ability to perform motor, cognitive (MOCA score ≥26/30) and sensory assessment * First symptomatic stroke more than 6 months ago * Upper limb paresis (≤4/5 on the MRC scale) * Feel ≥3/6 touch on the index and thumb fingers * Box and Blocks test score between 1 and 54 blocks / min
Exclusion criteria
* Contraindication to TMS (epilepsy, metal implants)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessing haptic effect during a dexterity exercise with and without sensory feedback: finger independence | 1 day | Comparison of finger independence, assessed with the Dextrain Manipulandum tool with and without sensory feedback (vibrations on the fingers). Measurement of the difference in motor performance between the condition with and without vibrations. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessing haptic effect during another dexterity exercise with and without sensory feedback: the force control of the index | 1 day | Comparison of finger force control, assessed with the dextrain manipulandum tool with and without sensory feedback (vibrations on the fingers). Measurement of the difference in motor performance between the condition with and without vibrations. |
| Assessing haptic effect during another dexterity exercise with and without sensory feedback: the rhythm capacity | 1 day | Comparison of rhythm capacity, assess with the dextrain manipulandum tool with and without sensory feedback (vibrations on the fingers). Measurement of the difference in motor performance between the condition with and without vibrations. |
| Correlation between clinical assessment and haptic measure | 1 day | Research the link between haptic feedback deficits and motor disorders of manual dexterity |
| Assessment of the benefits of the haptic measures | 1 day | Assessment of User Engagement scale to quantify the benefits perceived by the subject in relation to the haptic device. The score will be from 0 to 10, 10 meaning an excellent interest of the patient for the device |
| Assessment of the feasibility of the haptic measures | 1 day | Assessment of Intrinsic motivation survey to quantify the feasibility of the haptic device. The score will be from 0 to 7, 7 meaning an excellent motivation of the patient to use the device |
| Assessment of the impact of age on the dexterity performances (Finger independence, force control of the index and rhythm capacity) | 1 day | Comparison of the haptic effect (difference in motor performance between the conditions with and without vibrations on the fingers) between the groups of young healthy subjects and the group of healthy subjects of comparable age and sex to chronic stroke patients |
| Measurement of the manual dexterity facilitation between tactile (haptic device with vibrations on the fingers) and auditory feedback (sounds during the dexterity tasks) | 1 day | To compare the effect of tactile (vibrations on the fingers during dexterity assessments) modality facilitation versus auditory feedback on dexterity (finger independence, force control of the index and rhythm capacity) in stroke patients, young healthy subjects and healthy subjects of comparable age and sex to chronic stroke patients |
| Transcranial magnetic stimulation (TMS) | 1 day | Difference in cortical excitability in the anticipatory phase of force generation with the index finger between conditions without and with vibro-tactile stimulation |
| Study the test re-test reliability of the haptic device by comparing the haptic effect on dexterity assessed at the beginning and end of the session by the same evaluator | 1 day | The same examinator will assess haptic effect at the beginning and at the end of the session |
Contacts
Primary ContactPåvel Lindberg
Backup ContactSabrina Lekcir
Outcome results
None listed