Robotic devices have been used to rehabilitate walking function after stroke. Although results suggest that post-stroke patients benefit from this non-conventional therapy, there is no agreement on the optimal robot-assisted approaches to promote neurorecovery. Here we present a new robotic therapy protocol using a grounded exoskeleton perturbing the ankle joint based on tacit learning control. Ten healthy individuals and a post-stroke patient participated in the study and were enrolled in a pilot intervention protocol that involved performance of ankle movements following different trajectories via video game visual feedback. The system autonomously modulated task difficulty according to the performance to increase the challenge. We hypothesized that motor learning throughout training sessions would lead to increased corticospinal excitability of dorsi-plantarflexor muscles. Transcranial Magnetic Stimulation was used to assess the effects on corticospinal excitability. Improvements have been observed on task performance and motor outcomes in both healthy individuals and post-stroke patient case study. Tibialis Anterior corticospinal excitability increased significantly after the training; however no significant changes were observed on Soleus corticospinal excitability. Clinical scales showed functional improvements in the stroke patient. Our findings both in neurophysiological and performance assessment suggest improved motor learning. Some limitations of the study include treatment duration and intensity, as well as the non-significant changes in corticospinal excitability obtained for Soleus. Nonetheless, results suggest that this robotic training framework is a potentially interesting approach that can be explored for gait rehabilitation in post-stroke patients.
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http://dx.doi.org/10.3389/fbioe.2020.00113 | DOI Listing |
J Neural Eng
January 2025
Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, 4229 Pearl Road, Suite N4-13, Cleveland, Ohio, 44109-1998, UNITED STATES.
Ipsilateral motor evoked potentials (iMEPs) are believed to represent cortically evoked excitability of uncrossed brainstem-mediated pathways. In the event of extensive injury to (crossed) corticospinal pathways, which can occur following a stroke, uncrossed ipsilateral pathways may serve as an alternate resource to support the recovery of the paretic limb. However, iMEPs, even in neurally intact people, can be small, infrequent, and noisy, so discerning them in stroke survivors is very challenging.
View Article and Find Full Text PDFExp Brain Res
January 2025
Faculty of Sport, Technology and Health Sciences, St. Mary's University, Twickenham, Middlesex, UK.
The aim of this study was to assess if ischaemic preconditioning (IPC) can reduce pain perception and enhance corticospinal excitability during voluntary contractions. In a randomised, within-subject design, healthy participants took part in three experimental visits after a familiarisation session. Measures of pressure pain threshold (PPT), maximum voluntary isometric force, voluntary activation, resting twitch force, corticospinal excitability and corticospinal inhibition were performed before and ≥10 min after either, unilateral IPC on the right leg (3 × 5 min); a sham protocol (3 × 1 min); or a control (no occlusion).
View Article and Find Full Text PDFExp Physiol
January 2025
Strength and Conditioning Research Laboratory, College of Physical Education, University of Brasília, Brasília, Brazil.
This study examined the acute effects of dynamic stretching at different velocities on the neuromuscular system. Fourteen participants underwent four experimental sessions in random order: (1) control (lying at rest with the ankle in a neutral position); (2) slow velocity dynamic stretching (50 beats/min; SLOW); (3) moderate velocity dynamic stretching (70 beats/min; MOD); and (4) fast velocity dynamic stretching (90 beats/min; FAST). The stretching protocols consisted of four sets of 10 repetitions and targeted the plantar flexor muscles of the right ankle.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Neurology, Feinberg School of Medicine, Northwestern University, 303 E. Chicago Ave, Chicago, IL, 60611, USA.
Corticospinal motor neurons (CSMN), located in the motor cortex of the brain, are one of the key components of the motor neuron circuitry. They are in part responsible for the initiation and modulation of voluntary movement, and their degeneration is the hallmark for numerous diseases, such as amyotrophic lateral sclerosis (ALS), hereditary spastic paraplegia, and primary lateral sclerosis. Cortical hyperexcitation followed by in-excitability suggests the early involvement of cortical dysfunction in ALS pathology.
View Article and Find Full Text PDFSci Rep
December 2024
BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki and Aalto University School of Science, Helsinki, Finland.
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