Movements Improvements from Bimanual Interactive Training Post-Stroke

Artificially augmenting error during therapeutic training has shown promise in some recent studies. Here was explored visual error augmentation using a visual distortion that instantaneously shifts the subject’s cursor in the direction of error. 29 chronic stroke survivors were asked to practice a bimanual reaching task for approximately 40 minutes, for three weeks. The primary outcome of the study was Fugl-Meyer. Results show that the change in the mean values for the group who received the error augmentation between pre-evaluation and post-evaluation is 2.80, while between pre-evaluation and follow-up is 1.47. Even if both are below the minimal clinical importance difference of the scale, 5.6, results seem promising. Other kinematic outcomes were examined, such as range of motion deficit, asymmetry in the top-down direction, and the average movement time. All these three metrics were added together to obtain a composite error metric. Results show that the change in the mean values for the group who received the error augmentation between pre-evaluation and post-evaluation is -15.05, while between pre-evaluation and follow-up is -11.82. Because this is an error metric if the values are more negative, then the subject is improving. Such automated touch-free therapy may prove compelling because such approaches can reduce the expenses and complexity of using a robot while providing additional therapeutic support during arm rehabilitation, but further studies are necessary to highlight the benefit of the visual error augmentation without any haptic feedback and also the possible profiles of patients who can most benefit.