Impairments in Cognitive Control Using a Reverse Visually Guided Reaching Task Following Stroke.

Background: Cognitive and motor function must work together quickly and seamlessly to allow us to interact with a complex world, but their integration is difficult to assess directly. Interactive technology provides opportunities to assess motor actions requiring cognitive control.

Objective: To adapt a reverse reaching task to an interactive robotic platform to quantify impairments in cognitive-motor integration following stroke.

A postural unloading task to assess fast corrective responses in the upper limb following stroke.

Background: Robotic technologies to measure human behavior are emerging as a new approach to assess brain function. Recently, we developed a robot-based postural Load Task to assess corrective responses to mechanical disturbances to the arm and found impairments in many participants with stroke compared to a healthy cohort (Bourke et al, J NeuroEngineering Rehabil 12: 7, 2015). However, a striking feature was the large range and skewed distribution of healthy performance.

A robot-based behavioural task to quantify impairments in rapid motor decisions and actions after stroke.

Background: Stroke can affect our ability to perform daily activities, although it can be difficult to identify the underlying functional impairment(s). Recent theories highlight the importance of sensory feedback in selecting future motor actions. This selection process can involve multiple processes to achieve a behavioural goal, including selective attention, feature/object recognition, and movement inhibition.

Impaired corrective responses to postural perturbations of the arm in individuals with subacute stroke.

Background: Stroke is known to alter muscle stretch responses following a perturbation, but little is known about the behavioural consequences of these altered feedback responses. Characterizing impairments in people with stroke in their interactions with the external environment may lead to better long term outcomes. This information can inform therapists about rehabilitation targets and help subjects with stroke avoid injury when moving in the world.

A robotic object hitting task to quantify sensorimotor impairments in participants with stroke.

Background: Existing clinical scores of upper limb function often use observer-based ordinal scales that are subjective and commonly have floor and ceiling effects. The purpose of the present study was to develop an upper limb motor task to assess objectively the ability of participants to select and engage motor actions with both hands.

Methods: A bilateral robotic system was used to quantify upper limb sensorimotor function of participants with stroke.

The independence of deficits in position sense and visually guided reaching following stroke.

Background: Several studies have found correlations between proprioception and visuomotor function during stroke recovery, however two more recent studies have found no correlation. Unfortunately, most of the studies to date have been conducted with clinical assessments of sensation that are observer-based and have poor reliability. We have recently developed new tests to assess position sense and motor function using robotic technology.

Assessment of upper-limb sensorimotor function of subacute stroke patients using visually guided reaching.

Objective: Using robotic technology, we examined the ability of a visually guided reaching task to assess the sensorimotor function of patients with stroke.

Methods: Ninety-one healthy participants and 52 with subacute stroke of mild to moderate severity (26 with left- and 26 with right-affected body sides) performed an unassisted reaching task using the KINARM robot. Each participant was assessed using 12 movement parameters that were grouped into 5 attributes of sensorimotor control.

Quantitative assessment of limb position sense following stroke.

Background: Impairment of position sense of the upper extremity (UE) may impede activities of daily living and limit motor gains after stroke. Most clinical assessments of position sense rely on categorical or ordinal ratings by clinicians that lack sensitivity to change or the ability to discriminate subtle deficits.

Objective: Use robotic technology to develop a reliable, quantitative technique with a continuous scale to assess UE position sense following stroke.

A comparison of studies on the quality of life of primary caregivers of stroke survivors: a systematic review of the literature.

Background And Purpose: Few studies have been conducted on the quality of life (QOL) of primary caregivers of stroke survivors (with and without aphasia), with little consistency in the methods of evaluation. The purpose of this systematic review of the literature was to determine the appropriateness of study designs and instruments used to assess QOL in caregivers of stroke survivors.

Method: A comprehensive literature review was conducted to identify peer-reviewed articles of caregiver's QOL where CINAHL, MEDLINE, and PsycINFO databases were searched.

Toward benchmarks for stroke rehabilitation in Ontario, Canada.

Objective: Canadian benchmarking data do not exist for stroke rehabilitation services. This study used the FIM-function-related group (FIM-FRG) classification system to group patients and to describe the outcomes within each group. The intent was to begin to develop benchmarks for persons recovering from stroke in Canadian rehabilitation facilities.

First Clinical Experience with BION Implants for Therapeutic Electrical Stimulation.

The objective of this study was to assess the usability and safety of BION injectable neuromuscular microstimulators for therapeutic electrical stimulation (TES) to treat two conditions involving disuse atrophy: poststroke shoulder subluxation in hemiplegic subjects and knee osteoarthritis. Clinicians were provided with PC-based software to track implants and to design the exercise programs. Subjects self-administered TES (3 sessions/day, 10-30 min/session) for 6 or 12 weeks.