Evaluation of a Protocol for fMRI Assessment Associated with Augmented Reality Rehabilitation of Stroke Subjects

Gilda Assis,Alexandre Brandao,Gabriela Castellano,Ana Grasielle Dionísio Correa

doi:10.5753/jis.2019.717

Abstract

New technologies for rehabilitation involving Augmented Reality (AR) as a complement to conventional therapy have appeared in recent years. An earlier study for shoulder rehabilitation using the AR NeuroR computer system showed improved clinical outcomes for stroke patients. This study aims to analyze a proposed protocol to measure possible changes in functional brain connectivity associated with the use of the NeuroR system in the context of shoulder motor rehabilitation of post-stroke subjects. A pilot study was conducted with a poststroke patient, using resting-state functional magnetic resonance imaging (RS-fMRI). RS-fMRI signals were acquired pre and post use of the NeuroR system (pre-test and post-test), integrated into the patient’s rehabilitation program. Functional connectivity analysis of RS-fMRI was performed using the motor area as seed. The maximum connectivity value in the pre-test occurred in the ipsilesional parietal region while the maximum in the post-test was located in the ipsilesional frontal region. It was observed that the regions strongly associated with motor activity had higher connectivity values at post-test compared to pre-test. The proposed protocol is suitable and safe for verifying if functional brain connectivity was changed after the rehabilitation program with NeuroR training, indicating a possible neuroplasticity effect. Tests with a larger number of patients are still necessary.

Highlights

Neurological injury after stroke frequently leads to hemiparesis or partial paralysis and, despite conventional rehabilitation therapies, most stroke survivors report disability in at least one activity of daily living
Rehabilitation programs based on Virtual Reality (VR)/Augmented Reality (AR) have been highlighted as an alternative therapy for motor recovery [26]
The key role of a pilot study is to investigate the feasibility of a research experimental procedure to be used in a larger scale efficacy study

Summary

Introduction

Neurological injury after stroke frequently leads to hemiparesis or partial paralysis and, despite conventional rehabilitation therapies, most stroke survivors report disability in at least one activity of daily living. New technologies for rehabilitation involving virtual environments have received attention from the scientific community These technologies are being investigated to develop more effective strategies to help recover from physical disabilities resulting from stroke damage [3]– [5]. AR has emerged as a potential method in the field of rehabilitation, with the advantages of allowing a controllable environment and salient feedback, inducing the sense of presence, producing entertaining treatments and providing digital records of the rehabilitation session. This last feature allows for an individualized model of motor and cognitive learning, appropriate for each patient [7]

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