The Effects of Enhanced Self-Teleoperated Arm Therapy for Chronic Stroke Survivors

Stroke is a leading cause of disability in the United States with nearly 650,000 people each year experiencing upper extremity hemiparesis following a stroke. While several forms of rehabilitation exist in order to facilitate the motor recovery of post-stroke individuals, there is still significant room for improvement. Current rehabilitation therapies, such as constraint-induced movement and robotic-assisted movements, focus solely on the motor recovery of the more affected limb. Many stroke survivors see this lack of attention to bimanual coordination as a flaw in current therapeutic techniques, and feel that the function of both arms together is a worthwhile form of recovery. The purpose of this study is to determine the efficacy of self-teleoperated, robotic-assisted bimanual reaching therapy aimed at improving coordinated arm function. Twenty-six post-stroke individuals were asked to perform six, 45-minute bimanual reaching treatments while inside a Virtual Reality Robotic and Optical Operations Machine (VRROOM). Participants were either assigned to an error augmentation treatment group or a standard treatment group. Those assigned to the error augmentation treatment would have their errors magnified both visually and haptically (through robotic forces) during the tasks, while those undergoing the standard treatment would perform the reaching tasks without any augmentations. Clinical scores as well as a quantitative assessment were recorded throughout the treatment period to determine motor recovery. While the results of the clinical measures were not able to determine a significant improvement between the error augmentation and standard treatments, the therapy as a whole showed a clinically significant improvement in functional motor recovery. The quantitative assessment, however, did show that the error augmentation treatment was superior to the standard treatment in improving the bimanual coordination of post-stroke individuals. These findings suggest the potential of a new, self-teleoperated therapy of bimanual, error-augmented tasks as a viable post-stroke rehabilitation technique.