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Raveh, E., Portnoy, S., & Friedman, J. (2018). Adding vibrotactile feedback to a myoelectric-controlled hand improves performance when online visual feedback is disturbed. Hum Mov Sci, 58, 32–40.
Abstract: We investigated whether adding vibrotactile feedback to a myoelectric-controlled hand, when visual feedback is disturbed, can improve performance during a functional test. For this purpose, able-bodied subjects, activating a myoelectric-controlled hand attached to their right hand performed the modified Box & Blocks test, grasping and manipulating wooden blocks over a partition. This was performed in 3 conditions, using a repeated-measures design: in full light, in a dark room where visual feedback was disturbed and no auditory feedback – one time with the addition of tactile feedback provided during object grasping and manipulation, and one time without any tactile feedback. The average time needed to transfer one block was measured, and an infrared camera was used to give information on the number of grasping errors during performance of the test. Our results show that when vibrotactile feedback was provided, performance time was reduced significantly, compared with when no vibrotactile feedback was available. Furthermore, the accuracy of grasping and manipulation was improved, reflected by significantly fewer errors during test performance. In conclusion, adding vibrotactile feedback to a myoelectric-controlled hand has positive effects on functional performance when visual feedback is disturbed. This may have applications to current myoelectric-controlled hands, as adding tactile feedback may help prosthesis users to improve their functional ability during daily life activities in different environments, particularly when limited visual feedback is available or desirable.
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Levin, M. F., Banina, M. C., Frenkel-Toledo, S., Berman, S., Soroker, N., Solomon, J. M., et al. (2018). Personalized upper limb training combined with anodal-tDCS for sensorimotor recovery in spastic hemiparesis: study protocol for a randomized controlled trial. Trials, 19(1), 7.
Abstract: BACKGROUND: Recovery of voluntary movement is a main rehabilitation goal. Efforts to identify effective upper limb (UL) interventions after stroke have been unsatisfactory. This study includes personalized impairment-based UL reaching training in virtual reality (VR) combined with non-invasive brain stimulation to enhance motor learning. The approach is guided by limiting reaching training to the angular zone in which active control is preserved (“active control zone”) after identification of a “spasticity zone”. Anodal transcranial direct current stimulation (a-tDCS) is used to facilitate activation of the affected hemisphere and enhance inter-hemispheric balance. The purpose of the study is to investigate the effectiveness of personalized reaching training, with and without a-tDCS, to increase the range of active elbow control and improve UL function. METHODS: This single-blind randomized controlled trial will take place at four academic rehabilitation centers in Canada, India and Israel. The intervention involves 10 days of personalized VR reaching training with both groups receiving the same intensity of treatment. Participants with sub-acute stroke aged 25 to 80 years with elbow spasticity will be randomized to one of three groups: personalized training (reaching within individually determined active control zones) with a-tDCS (group 1) or sham-tDCS (group 2), or non-personalized training (reaching regardless of active control zones) with a-tDCS (group 3). A baseline assessment will be performed at randomization and two follow-up assessments will occur at the end of the intervention and at 1 month post intervention. Main outcomes are elbow-flexor spatial threshold and ratio of spasticity zone to full elbow-extension range. Secondary outcomes include the Modified Ashworth Scale, Fugl-Meyer Assessment, Streamlined Wolf Motor Function Test and UL kinematics during a standardized reach-to-grasp task. DISCUSSION: This study will provide evidence on the effectiveness of personalized treatment on spasticity and UL motor ability and feasibility of using low-cost interventions in low-to-middle-income countries. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02725853 . Initially registered on 12 January 2016.
Keywords: Neurorehabilitation; Spasticity; Spatial threshold; Stroke; tDCS
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