Impairment-based 3-D robotic intervention improves upper extremity work area in chronic stroke: Targeting abnormal joint torque coupling with progressive shoulder abduction loading

Michael D Ellis*, Theresa Sukal Moulton, Julius P A Dewald

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

The implementation of a robotic system (ACT3D) that allowed for a quantitative measurement of abnormal joint torque coupling in chronic stroke survivors and, most importantly, a quantitative means of initiating and progressing an impairment-based intervention, is described. Individuals with chronic moderate to severe stroke (n = 8) participated in this single-group pretest-posttest design study. Subjects were trained over eight weeks by progressively increasing the level of shoulder abduction loading experienced by the participant during reaching repetitions as performance improved. Reaching work area was evaluated pre- and postintervention for ten different shoulder abduction loading levels along with isometric single-joint strength and a qualitative clinical assessment of impairment. There was a significant effect of session (pre versus post) with an increase in reaching work area, despite no change in single-joint strength. This data suggests that specifically targeting the abnormal joint torque coupling impairment through progressive shoulder abduction loading is an effective strategy for improving reaching work area following hemiparetic stroke. Application of robotics, namely, the ACT3D, allowed for quantitative control of the exercise parameters needed to directly target the synergistic coupling impairment. The targeted reduction of abnormal joint torque coupling is likely the key factor explaining the improvements in reaching range of motion achieved with this intervention.

Original languageEnglish (US)
Pages (from-to)549-555
Number of pages7
JournalIEEE Transactions on Robotics
Volume25
Issue number3
DOIs
StatePublished - Apr 21 2009

Keywords

  • Arm
  • Kinematics
  • Kinetics
  • Rehabilitation robotics
  • Stroke

ASJC Scopus subject areas

  • Control and Systems Engineering
  • Computer Science Applications
  • Electrical and Electronic Engineering

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