The overall objective of the study is to test whether the use of small electrical currents to stimulate proprioceptors of the upper limb has potential for improving robot-assisted upper-limb rehabilitation in stroke survivors.
Study participants will be instructed to perform upper-limb movements using a system designed for upper-limb rehabilitation (Armeo Spring by Hocoma AG). The system provides subjects with unloading of the stroke-affected arm thus facilitating the performance of upper-limb movements. The system will be used to track the movements of the stroke-affected arm. Simultaneously, a custom-designed system (a prototype developed by the investigators) will be used to deliver small electrical currents to the arm. We hypothesize that the currents delivered to the arm will improve the accuracy of the movements performed by study participants. To assess if delivering small currents to the arm has an effect on the accuracy of the movements performed by the study participants, they will receive actual stimulation for some trials and sham stimulation for other trials. Because the investigators will deliver very small currents, study participants will be unable to perceive such currents and hence tell if they are performing the movements while receiving actual or sham stimulation. By comparing trials performed while subjects receive actual stimulation with trials performed while subjects received sham stimulation, the investigators will determine if the stimulation has an effect on the accuracy of the movements performed by the subjects. It is worth noticing that the investigators collected primary outcome data to assess changes associated with the use of actual stimulation vs sham stimulation. Data during a follow-up session was also collected, but not for the purpose of collecting outcome measures.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
1
This is a device developed by the investigators to produce sub-sensory electrical stimulation delivered via subcutaneous electrodes placed on the skin.
Spaulding Rehabilitation Hospital Boston
Boston, Massachusetts, United States
Fugl-Meyer Assessment
Subjects are asked to perform upper-limb movements from which a therapist can assess the severity of movement abnormalities (e.g. flexion synergies)
Time frame: Changes in Fugl-Meyer Assessment score with vs without stimulation
Jebsen-Taylor Hand Function Test
Subjects are asked to perform a set of functional movements from which a therapist can assess subjects' functional limitations
Time frame: Changes in Jebsen-Taylor Hand Function Test score with vs without stimulation
Motor Activity Log
Subjects are asked about the amount and quality of use of their stroke-affected arm during the performance of daily activities
Time frame: Change in Motor Activity Log score with vs without stimulation
Modified Ashworth Scale
A therapist examines subjects to assess the severity of spasticity
Time frame: Change in Modified Ashworth Scale score with vs without stimulation
Box and Block test
Subjects are asked to move as many small wooden blocks as possible from one to box to another in a set amount of time
Time frame: Change in Box and Block test score with vs without stimulation
Grip strength
A hand dynamometer is used to measure grip strength
Time frame: Change in grip strength with vs without stimulation
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