Article

Robotics is rapidly emerging as a viable approach to enhance motor recovery after
disabling stroke. Current principles of cognitive motor learning recognize a
positive relationship between reward and motor learning. Yet no prior studies
have established explicitly whether reward improves the rate or efficacy of
robotics-assisted rehabilitation or produces neurophysiologic adaptations
associated with motor learning. We conducted a 3 wk, 9-session clinical pilot
with 10 people with chronic hemiparetic stroke, randomly assigned to train with
an impedance-controlled ankle robot (anklebot) under either high reward (HR) or
low reward conditions. The 1 h training sessions entailed playing a seated video
game by moving the paretic ankle to hit moving onscreen targets with the anklebot
only providing assistance as needed. Assessments included paretic ankle motor
control, learning curves, electroencephalograpy (EEG) coherence and spectral
power during unassisted trials, and gait function. While both groups exhibited
changes in EEG, the HR group had faster learning curves (p = 0.05), smoother
movements (p </= 0.05), reduced contralesional-frontoparietal coherence (p </=
0.05), and reduced left-temporal spectral power (p </= 0.05). Gait analyses
revealed an increase in nonparetic step length (p = 0.05) in the HR group only.
These results suggest that combining explicit rewards with novel anklebot
training may accelerate motor learning for restoring mobility.
- Robotique

Langue : ANGLAIS