Improving Recovery After Stroke Via Electrical Stimulation of Proprioceptors
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | August 2011 |
| End Date: | December 2016 |
The overall objective of the study is to test whether the use of small electrical currents
to stimulate proprioceptors of the upper limb can result into enhancing the benefits of
robotic-assisted therapy. The stimulation technique used is "Stochastic Resonance" (SR). In
previous studies, it has been shown that SR has the effect of increasing afferent traffic
from Golgi tendon organs and muscle spindles. This effect is referred to as "sensory
enhancement". Also, SR has been shown to improve the results of physical therapy in an
animal model. The study is intended to explore the use of SR in stroke survivors.
to stimulate proprioceptors of the upper limb can result into enhancing the benefits of
robotic-assisted therapy. The stimulation technique used is "Stochastic Resonance" (SR). In
previous studies, it has been shown that SR has the effect of increasing afferent traffic
from Golgi tendon organs and muscle spindles. This effect is referred to as "sensory
enhancement". Also, SR has been shown to improve the results of physical therapy in an
animal model. The study is intended to explore the use of SR in stroke survivors.
Aim 1: To establish a procedure to optimize the delivery of the SR stimulation to the target
organs. The investigators hypothesize that there is an optimal level of stimulation for an
individual that will lead to the highest level of sensory enhancement. The investigators
will determine such level of stimulation by measuring the impact of different stimulation
levels on the quality of the movements performed by subjects while being stimulated.
Aim 2: To gather preliminary evidence of the effectiveness of SR stimulation in stroke
rehabilitation. The investigators plan to combine the optimal SR stimulation, determined in
Aim 1, with robotic-assisted rehabilitation to perform a preliminary assessment of the size
of the improvement associated with the delivery of SR stimulation. The investigators
hypothesize that robotic-assisted rehabilitation in combination with SR stimulation of
proprioceptors leads to larger motor gains than robotic-assisted rehabilitation alone.
organs. The investigators hypothesize that there is an optimal level of stimulation for an
individual that will lead to the highest level of sensory enhancement. The investigators
will determine such level of stimulation by measuring the impact of different stimulation
levels on the quality of the movements performed by subjects while being stimulated.
Aim 2: To gather preliminary evidence of the effectiveness of SR stimulation in stroke
rehabilitation. The investigators plan to combine the optimal SR stimulation, determined in
Aim 1, with robotic-assisted rehabilitation to perform a preliminary assessment of the size
of the improvement associated with the delivery of SR stimulation. The investigators
hypothesize that robotic-assisted rehabilitation in combination with SR stimulation of
proprioceptors leads to larger motor gains than robotic-assisted rehabilitation alone.
Inclusion Criteria:
- unilateral and cortical, subcortical, or cerebellar stroke
- 6 months post-stroke
- Upper extremity impairments but able to move upper extremity against gravity 25% of
the range
- Ability to understand directions and follow simple instructions
- Medically stable
- Upper Extremity Fugl-Meyer between 28 and 55
- At least four (4) months since last botox treatment
- Mini-Mental State Examination (MMSE) ≥ 23
Exclusion Criteria:
- Participation in other forms of therapy/ intervention for upper extremity motor
recovery
- Upper extremity or trunk fractures
- Severe fixed contractures in the upper extremities
- Severe perceptual deficits or visual field impairments
- Severe cognitive deficits
- Pregnant women
- Presence of an implanted electrically operated medical device
- Evidence of more than one clinical stroke
- Serious medical or neurological illness
- History of head trauma or cerebral infectious disease
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