Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, April 12, 2023

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

What happened to this? It's only been 14 years! If your doctor doesn't know you don't have a functioning stroke doctor and you need to call the president to ask when competent persons will be hired.

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

2009, Journal of NeuroEngineering and Rehabilitation
 Lorenzo Masia*
1
, Maura Casadio
2
, Psiche Giannoni
3
, Giulio Sandini
1,2
and Pietro Morasso
2
 Addresses:
 1
Robotics Brain and Cognitive Science Dept, Italian Institute of Technology (IIT), Genoa, Italy,
 2
Dept of Informatics, Systems and Telematics, University of Genova, Italy and
 3
 ART Rehabilitation and Educational Center srl, Genoa, Italy E-mail: Lorenzo Masia* - lorenzo.masia@iit.it ; Maura Casadio - maura.casadio@dist.unige.it ; Psiche Giannoni - psichegi@tin.it ; Giulio Sandini - giulio.sandini@iit.it ; Pietro Morasso - pietro.morasso@unige.it  *Corresponding author
Published: 7 December 2009 Received: 24 March 2009
 Journal of NeuroEngineering and Rehabilitation
 2009,
 6
:44 doi: 10.1186/1743-0003-6-44 Accepted: 7 December 2009This article is available from: http://www.jneuroengrehab.com/content/6/1/44
©
 2009 Masia et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:
 In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life). Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of  jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion) of the different DoFs (degrees of Freedom).
Methods:
 The IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE), Abduction/Adduction (AA) andPronation/Supination (PS). Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the “easier” to the “more difficult ” angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns.
Results:
 Three stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the beginning and at the end of the test therapy session and the results suggest a positive trend.
Conclusion:
 The positive outcomes of the preliminary tests motivate the planning of a clinical trial and provide experimental evidence for defining appropriate inclusion/exclusion criteria.

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