Bimanual motor skill learning and robotic assistance for chronic hemiparetic stroke: a randomized controlled trial  

作　　者：Maral Yeganeh Doost Benoît Herman Adrien Denis Julien Sapin Daniel Galinski Audrey Riga Patrice Laloux Benoît Bihin Yves Vandermeeren 

机构地区：[1]UCLouvain,CHU UCL Namur–site Mont-Godinne,Department of Neurology,Stroke Unit,Yvoir,Belgium [2]UCLouvain,Institute of NeuroScience(IoNS),Clinical neuroscience division(NEUR)division,Brussels,Belgium [3]UCLouvain,Louvain Bionics,Louvain-la-Neuve,Belgium [4]UCLouvain,Institute of Mechanics,Materials and Civil Engineering(iMMC),Louvain-la-Neuve,Belgium [5]AXINESIS SA,Wavre,Belgique [6]Scientific Support Unit,CHU UCL Namur–site Mont-Godinne,Yvoir,Belgium

出　　处：《Neural Regeneration Research》2021年第8期1566-1573,共8页中国神经再生研究（英文版）

基　　金：supported by the following grants Fonds de la Recherche Scientifique–FNRS 1.R.506.16;1.R.506.18&1.R.506.20;Fonds de la Recherche Scientifique Médicale(FRSM)3.4.525.08.F;Fonds Spécial de Recherche(FSR)from the UCLouvain;Fondation Van Goethem-Brichant;Fondation Mont-Godinne;supported by the following grants FRNS-FRIA n°F3/5/5-MCF/ROI/BC-19727 and F3/5/5-MCF/XH/FC-17514;Fondation Mont-Godinne 2018;supported by grants from the Fondation Mont-Godinne 2015-2016;Fonds Spécial de Recherche(FSR)of the UCLouvain 2016-2018;Fondation Roi Baudouin/Fonds Amélie 2018-2019。

摘　　要：Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor skill learning(biMSkL) more than training under the active mode in stroke patients. Twenty-six healthy individuals(HI) and 23 chronic hemiparetic stroke patients with a detectable lesion on MRI or CT scan, who demonstrated motor deficits in the upper limb, were randomly allocated to two parallel groups. The protocol included a two-day training on a new bimanual cooperative task, LIFT-THE-TRAY, under either the active or activeassisted modes(where assistance decreased in a pre-determined stepwise fashion) with the bimanual version of the REAplan? robotic device. The hypothesis was that the active-assisted mode would result in greater biMSkL than the active mode. The biMSkL was quantified by a speed-accuracy trade-off(SAT) before(T1) and immediately after(T2) training on days 1 and 2(T3 and T4). The change in SAT after 2 days of training(T4/T1) indicated that both HI and stroke patients learned and retained the bimanual cooperative task. After 2 days of training, the active-assisted mode did not improve biMSkL more than the active mode(T4/T1) in HI nor stroke patients. Whereas HI generalized the learned bimanual skill to different execution speeds in both the active and active-assisted subgroups, the stroke patients generalized the learned skill only in the active subgroup. Taken together, the active-assisted mode, applied in a pre-determined stepwise decreasing fashion, did not improve biMSkL more than the active mode in HI and stroke subjects. Stroke subjects might benefit more from robotic assistance when applied "as-needed." This study was approved by the local ethical committee(Comité d'éthique médicale, CHU UCL Namur, MontGodinne, Yvoir, Belgium;Internal number: 54/2010, Eudra CT number: NUB B039201317382) on July 14, 2016 and was registered with ClinicalTrial

关 键 词：BIMANUAL HEMIPARESIS motor learning rehabilitation ROBOTIC robotic assistance slacking stroke retention 

分 类 号：R743.3[医药卫生—神经病学与精神病学]