Abstract
BackgroundRobot-assisted therapy in patients with neurological disease is an attempt to improve function in a moderate to severe hemiparetic arm. A better understanding of cortical modifications after robot-assisted training could aid in refining rehabilitation therapy protocols for stroke patients. Modifications of cortical activity in healthy subjects were evaluated during voluntary active movement, passive robot-assisted motor movement, and motor imagery tasks performed under unimanual and bimanual protocols.MethodsTwenty-one channel electroencephalography (EEG) was recorded with a video EEG system in 8 subjects. The subjects performed robot-assisted tasks using the Bi-Manu Track robot-assisted arm trainer. The motor paradigm was executed during one-day experimental sessions under eleven unimanual and bimanual protocols of active, passive and imaged movements. The event-related-synchronization/desynchronization (ERS/ERD) approach to the EEG data was applied to investigate where movement-related decreases in alpha and beta power were localized.ResultsVoluntary active unilateral hand movement was observed to significantly activate the contralateral side; however, bilateral activation was noted in all subjects on both the unilateral and bilateral active tasks, as well as desynchronization of alpha and beta brain oscillations during the passive robot-assisted motor tasks. During active-passive movement when the right hand drove the left one, there was predominant activation in the contralateral side. Conversely, when the left hand drove the right one, activation was bilateral, especially in the alpha range. Finally, significant contralateral EEG desynchronization was observed during the unilateral task and bilateral ERD during the bimanual task.ConclusionsThis study suggests new perspectives for the assessment of patients with neurological disease. The findings may be relevant for defining a baseline for future studies investigating the neural correlates of behavioral changes after robot-assisted training in stroke patients.
Highlights
Robot-assisted therapy in patients with neurological disease is an attempt to improve function in a moderate to severe hemiparetic arm
We evaluated the modifications of cortical activity during voluntary active movement, passive robot-assisted movement, and motor imagery performed under unimanual and bimanual protocols
The mean alpha and beta maps showed a decrease in event-related desynchronization (ERD) over the central SM1 areas, contralateral and ipsilateral to the movement (C3 and C4) to the maps obtained during right hand movement
Summary
Robot-assisted therapy in patients with neurological disease is an attempt to improve function in a moderate to severe hemiparetic arm. A better understanding of cortical modifications after robot-assisted training could aid in refining rehabilitation therapy protocols for stroke patients. Robotic therapy in patients with neurological disease is an attempt to improve function in a moderate to severe hemiparetic arm. The effects of training with the BMT, a robotic arm trainer that enables unilateral and bilateral passive and active practice of one degree of freedom pronation and supination movement of the forearm, as well as wrist dorsiflexion and volarflexion, were first investigated by Hesse in patients with sub-acute stroke and severe upper limb hemiparesis [5]. Stroke patients practiced 20 minutes every workday for six weeks using BMT-assisted bimanual active and passive movement of the forearm and wrist. Arm training with the BMT led to a greater improvement in upper limb motor control compared with the control group which had received only electrical muscle stimulation of the paretic wrist extensors
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