Robotically Driven Error Augmentation Training Enhances Post-Stroke Arm
Motor Recovery
Abstract
Error Augmentation training using a robotic interface is thought to
promote motor recovery by enhancing proprioceptive feedback, which
motivates and challenges patients to optimize their performance during
training. Here, we investigated the effectiveness of robotic Error
Augmentation training on motor recovery after a stroke, compared to
standard robotic training in a null field. Post-stroke patients were
randomly assigned to one of two groups: a study group (n=9) that was
trained on a 3D robotic system applying Error Augmentation forces, and a
control group (n=7) that carried out the same protocol in null field
conditions. The robotic rehabilitation intervention was applied in
addition to the standard rehabilitation protocol of the rehabilitation
center. Error Augmentation training increased clinical scores compared
to standard robotic training by 266% on the Motor Assessment Scale, and
88% on the Fugl-Meyer scale. The Motor Assessment Scale scores were
significantly correlated with the Fugl-Meyer scores (p=0.03, r=0.541).
There were more movement errors on the initial trials of the game
sequence using the DeXtreme robotic device with Error Augmentation
compared to trials with no force field. This difference vanished however
after 10 trials. Error Augmentation training decreased the number of
movement units and jerkiness compared to the control treatment. These
findings suggest that Error Augmentation training may enhance motor
performance possibly through motor adaptation.