Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, L.go Daneo, Genoa, 16132, Italy.
J Neuroeng Rehabil. 2017 Oct 16;14(1):107. doi: 10.1186/s12984-017-0316-0.
Postural control deficits are common in stroke survivors and often the rehabilitation programs include balance training based on visual feedback to improve the control of body position or of the voluntary shift of body weight in space. In the present work, a group of chronic stroke survivors, while sitting on a force plate, exercised the ability to control their Center of Pressure with a training based on continuous visual feedback. The goal of this study was to test if and to what extent chronic stroke survivors were able to learn the task and transfer the learned ability to a condition without visual feedback and to directions and displacement amplitudes different from those experienced during training.
Eleven chronic stroke survivors (5 Male - 6 Female, age: 59.72 ± 12.84 years) participated in this study. Subjects were seated on a stool positioned on top of a custom-built force platform. Their Center of Pressure positions were mapped to the coordinate of a cursor on a computer monitor. During training, the cursor position was always displayed and the subjects were to reach targets by shifting their Center of Pressure by moving their trunk. Pre and post-training subjects were required to reach without visual feedback of the cursor the training targets as well as other targets positioned in different directions and displacement amplitudes.
During training, most stroke survivors were able to perform the required task and to improve their performance in terms of duration, smoothness, and movement extent, although not in terms of movement direction. However, when we removed the visual feedback, most of them had no improvement with respect to their pre-training performance.
This study suggests that postural training based exclusively on continuous visual feedback can provide limited benefits for stroke survivors, if administered alone. However, the positive gains observed during training justify the integration of this technology-based protocol in a well-structured and personalized physiotherapy training, where the combination of the two approaches may lead to functional recovery.
姿势控制缺陷在中风幸存者中很常见，康复计划通常包括基于视觉反馈的平衡训练，以改善对身体姿势或体重在空间中的自主转移的控制。在目前的工作中，一组慢性中风幸存者在坐在测力板上时，通过基于连续视觉反馈的训练来锻炼控制其压力中心的能力。本研究的目的是测试慢性中风幸存者是否能够学习任务，并将所学的能力转移到没有视觉反馈的情况下，以及与训练中经历的方向和位移幅度不同的情况下。
11 名慢性中风幸存者（5 名男性-6 名女性，年龄：59.72±12.84 岁）参加了这项研究。受试者坐在定制的力平台上的凳子上。他们的压力中心位置被映射到计算机显示器上的光标坐标。在训练过程中，光标位置始终显示，受试者通过移动躯干将压力中心移动到目标位置。在训练前后，受试者需要在没有光标视觉反馈的情况下到达训练目标以及位于不同方向和位移幅度的其他目标。
在训练过程中，大多数中风幸存者能够完成所需的任务，并在持续时间、平滑度和运动幅度方面提高他们的表现，尽管在运动方向方面没有提高。然而，当我们移除视觉反馈时，他们中的大多数人在训练前的表现方面没有任何改善。
本研究表明，仅基于连续视觉反馈的姿势训练，如果单独进行，对中风幸存者的益处有限。然而，在训练过程中观察到的积极收益证明了将这项基于技术的方案整合到一个结构化和个性化的物理治疗训练中是合理的，在这种训练中，两种方法的结合可能会导致功能恢复。
