Visuomotor Ankle Training on a Stiffness-Controlled Robotic Platform Improves Ankle Motor Control and Lower Extremity Function in Chronic Stroke Survivors

Lindsey Hennington, Varun Nalam, Megan C. Eikenberry, Carolyn L. Kinney, Hyunglae Lee

Research output: Contribution to journalArticlepeer-review

Abstract

This study demonstrated the feasibility of a 6-week, visuomotor ankle training program using a stiffness-controlled, 2 degree-of-freedom robotic platform and investigated its effectiveness on paretic ankle motor control and lower extremity function in patients with stroke. In this feasibility study, two chronic stroke survivors with right hemiparesis participated in the training involving ankle motor control for 12 sessions over 6 weeks. While standing on a compliant robotic platform that simulated rotational stiffness comparable to the ankle joint stiffness of unimpaired individuals, participants performed visually-guided target reaching ankle movement tasks in the sagittal and frontal planes, i.e., dorsiflexion, plantarflexion, inversion, and eversion directions, totaling 160 trials per session. Both participants successfully completed the 6-week training without any discomfort or safety issues. This visuomotor ankle training on the compliant robotic platform contributed to the significant improvement of paretic ankle motor control, evidenced by less variable, smoother, and faster ankle movements. At the conclusion of the training, a significant improvement in the fast walking speed was observed in both participants (over 20% in one subject and over 50% in the other), validating clinical relevance of the training. The Berg Balance Scale score evaluating postural balance was also improved, but only one subject showed a clinically significant improvement (8 points), while the other did not reach the clinical significance (2 points). These results suggest the potential benefits of the visuomotor ankle training program using a stiffness-controlled robotic platform to patients with stroke by providing a desirable therapeutic target towards improved ankle motor control and lower extremity function.

Original languageEnglish (US)
Article number8887198
Pages (from-to)237-246
Number of pages10
JournalIEEE Transactions on Medical Robotics and Bionics
Volume1
Issue number4
DOIs
StatePublished - Nov 2019

Keywords

  • Ankle rehabilitation
  • lower extremity robotic therapy
  • robot-aided rehabilitation
  • robotic ankle therapy

ASJC Scopus subject areas

  • Computer Science Applications
  • Artificial Intelligence
  • Human-Computer Interaction
  • Control and Optimization
  • Biomedical Engineering

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