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UBC Theses and Dissertations

Reducing compensatory movements in stroke therapy through the use of robotic devices and augmented feedback Valdes Benavides, Bulmaro Adolfo

Abstract

Compensatory movements are commonly employed by stroke survivors to adapt to the loss of motor function. However, their long-term use can be detrimental to post-stroke recovery of function. In this work, we focused on trunk displacement, which is a compensatory movement that stroke survivors use when reaching forward. Current therapeutic practices to reduce this tendency rely on the use of physical restraints to secure a person to a chair. An alternate approach to reduce compensation is the use of active technology that delivers augmented feedback about trunk movement. Using this methodology provides several advantages over physical restraints, such as: the person is actively involved in the planning and executing of the movement rather than relying on a physical barrier that continuously prevents trunk movement; the feedback intensity, frequency, and thresholds can easily be modified in real time; the system is less intrusive as it does not require the person to be strapped or secured to a chair by someone else; it can be used safely without direct supervision; the trunk compensation feedback can be used as a variable inside a motivating video game scenario. This dissertation is comprised of three studies to investigate: the extent of stroke survivors’ trunk displacement when reaching forward to targets at different heights (Study 1), the use of visual and force feedback (Study 2), and the importance of including game scores (Study 3) to reduce trunk compensation. The results from these studies suggest that target height influences the degree of trunk compensation of hemiparetic participants. In addition, the use of visual and force feedback to cue participants about their level of trunk compensation can lead to a reduction of this movement. Similarly, the use of game scores resulted in a reduction of trunk compensation. No feedback modality or combination was superior to another for reducing trunk displacement. The findings from this work suggest that the use of augmented feedback is a viable approach to reduce trunk compensation in hemiparetic stroke survivors. These ideas should be tested in long-term interventions before we can make a final recommendation to the rehabilitation community. Supplementary/video material is available at: http://hdl.handle.net/2429/62493

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Attribution-NonCommercial-NoDerivatives 4.0 International

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