Effects of Robotic Neurorehabilitation on Body Representation in Individuals with Stroke: A Preliminary Study Focusing on an EEG-Based Approach.
Augmented visuomotor feedback
Body representation (BR)
Gait rehabilitation
Mirror neuron system (MNS)
Robot-aided gait training (RAGT)
Journal
Brain topography
ISSN: 1573-6792
Titre abrégé: Brain Topogr
Pays: United States
ID NLM: 8903034
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
13
03
2020
accepted:
15
02
2021
pubmed:
5
3
2021
medline:
1
6
2021
entrez:
4
3
2021
Statut:
ppublish
Résumé
Patients with stroke can experience a drastic change in their body representation (BR), beyond the physical and psychological consequences of stroke itself. Noteworthy, the misperception of BR could affect patients' motor performance even more. Our study aimed at evaluating the usefulness of a robot-aided gait training (RAGT) equipped with augmented visuomotor feedback, expected to target BR (RAGT + VR) in improving lower limb sensorimotor function, gait performance (using Fugl-Meyer Assessment scale for lower extremities, FMA-LE), and BR (using the Body Esteem Scale-BES- and the Body Uneasiness Test-BUT), as compared to RAGT - VR. We also assessed the neurophysiologic basis putatively subtending the BR-based motor function recovery, using EEG recording during RAGT. Forty-five patients with stroke were enrolled in this study and randomized with a 1:2 ratio into either the RAGT + VR (n = 30) or the RAGT - VR (n = 15) group. The former group carried out rehabilitation training with the Lokomat©Pro; whereas, the latter used the Lokomat©Nanos. The rehabilitation protocol consisted of 40 one-hour training sessions. At the end of the training, the RAGT + VR improved in FMA-LE (p < 0.001) and BR (as per BES, (p < 0.001), and BUT, (p < 0.001)) more than the RAGT- did (p < 0.001). These differences in clinical outcomes were paralleled by a greater strengthening of visuomotor connectivity and corticomotor excitability (as detected at the EEG analyses) in the RAGT + VR than in the RAGT - VR (all comparisons p < 0.001), corresponding to an improved motor programming and execution in the former group.We may argue that BR recovery was important concerning functional motor improvement by its integration with the motor control system. This likely occurred through the activation of the Mirror Neuron System secondary to the visuomotor feedback provision, resembling virtual reality. Last, our data further confirm the important role of visuomotor feedback in post-stroke rehabilitation, which can achieve better patient-tailored improvement in functional gait by means of RAGT + VR targeting BR.
Identifiants
pubmed: 33661430
doi: 10.1007/s10548-021-00825-5
pii: 10.1007/s10548-021-00825-5
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
348-362Références
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