Use of Sensory Substitution to Improve Arm Control After Stroke

Not yet recruiting

Phase N/A Results N/A

Trial Description

Supplementing or augmenting sensory information to those who have lost proprioception after stroke could help improve functional control of the arm. Twenty-eight subjects will be recruited to a single site to evaluate the ability of various forms of vibrotactile stimulation to improve motor function, and to determine which locations of stimulation may optimize function. Participants will be tested in performing reaching movements and stabilization movements as well as more functional tasks such as simulated drinking from a glass

Detailed Description

This study has two distinct aims. In aim 1, data will be collected across four days:
Day 1: Participants complete baseline screening including a test of cognition (Montreal Cognitive Assessment), clinical tests of sensory and motor function (Fugl-Meyer Assessment, two-point discrimination, vibration sensation) and a robotic test of proprioception (Arm Movement Detection Test).
Day 2: Participants will have their more affected hand wrapped around a robot handle. They will either perform reaching-type movements or hold the handle still if it attempts to make small movements. During these tasks, participants will receive vibrotactile feedback on the other arm which will provide information about hand position and/or hand speed to guide the movements.
Day 3: Participants will perform the holding-still task from the previous day while also performing a grip task. They will be cued to lightly squeeze and then relax their grip in the more affected hand while they are holding the handle as still as possible. During this time, they will be provided vibrotactile feedback to help them maintain hand position.
Day 4: Participants will perform the same task as the previous day. In this experiment, the vibrotactile feedback will be provided to the opposite arm, opposite thigh or on the same (grasping) arm.
In aim 2, data will be collected across ten days:
Day 1: Participants complete baseline screening including a test of cognition (Montreal Cognitive Assessment), clinical tests of sensory and motor function (Fugl-Meyer, two-point discrimination, vibration sensation) and a robotic test of proprioception (Arm Movement Detection Test).
Days 2-10: Participants will use the more affected arm to reach to specific 'unseen' targets in three-dimensional space, using vibrotactile feedback to guide the movement of the arm. Once participants reach the location, they will be asked to squeeze and release the fingers. View of a computer monitor will also be used during part of the experiment to help the participants guide the hand. Participants will also be asked to perform a simulated feeding task at the beginning or end of practice on each day.

Conditions

Interventions

  • Vibrotactile stimulation Behavioral
    Intervention Desc: Non-invasive, computer-controlled miniature tendon vibrators, similar to those used in FitBit activity monitors.
    ARM 1: Kind: Experimental
    Label: Stroke Cohort - Optimize Delivery
    Description: Aim 1 intervention: Vibrotactile stimulation. An optimal location and style of vibrotactile feedback for reach and stabilization behaviors will be determined.
    ARM 2: Kind: Experimental
    Label: Stroke Cohort - Extended Training
    Description: Aim2 intervention: Vibrotactile stimulation. Progressive training from simple to more complex reaching and stabilizing tasks using vibrotactile feedback to guide performance

Outcomes

Type Measure Time Frame Safety Issue
Primary Root Mean Square Kinematic Error across experimental sessions spanning a typical time frame of 1 to 3 weeks

Sponsors