Robotics, virtual games improve motor recovery in stroke patients

Researchers from Johns Hopkins University in Baltimore set out to analyze the effects of motor recovery and motor learning using rehabilitation techniques using a robotic arm and virtual games.

Motor learning is being investigated to see if it can improve recovery and speed development. The study, lead by Pablo Celnik, MD, director of the Department of Physical Medicine and Rehabilitation at Johns Hopkins, examined motor learning in healthy control participants and stroke survivors with motor impairment.

The study compared a control group of unaffected participant with stoke patients categorized as having mild-to-moderate or moderate-to-severe motor impairment. All participants were fitted with a robotic wearable that positioned their dominant arm at 90 degrees and had to control a cursor to hit certain boxes within a virtual game. The speed-accuracy trade-off function (SAF) was measured in each group to assess the performance in each group.

The SAF of each group correctly corresponded with the level of impairment within each group. The training of the moderate-to-severe group was able to bring their score up to match the baseline scores of the mild-to-moderate group and the training of the mild-to-moderate group was able to match the baseline score of the control group. While the two stroke groups were able to improve their baseline scores, they could not reach equivalent scores and showed different signs of improvements in their overall performance.

"What we found is that physical rehab is not going to change the weakness caused by damaged brain cells in chronic patients, but it is going to change how well they can perform certain tasks, which can have a huge impact on a patient's daily life," said Celnik. “This is good news for patients because it means that even when there is little likelihood of further neurological recovery, it means I can still teach them new tasks through training. What is important is to not create false expectations of neurological recovery, while at the same time being hopeful that patients can learn within the boundaries of their neurological deficit to improve their lives."