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Enhancing Stroke Rehabilitation: Higher Rewards Improve Motor Control and Brain Efficiency in Ankle Robotics Training

This study explores utilizing impedance-controlled ankle robots for enhanced lower-limb rehabilitation after stroke, with overt rewards and augmented feedback. Results reveal that high reward conditions lead to faster learning curves, smoother movements, and improved brain coherence. Combining explicit rewards with anklebot training may accelerate motor learning and mobility restoration post-stroke.

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Enhancing Stroke Rehabilitation: Higher Rewards Improve Motor Control and Brain Efficiency in Ankle Robotics Training

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  1. Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke Ronald N. Goodman, PhD; Jeremy C. Rietschel, PhD; Anindo Roy, PhD; Brian C. Jung, BS; Jason Diaz, MS; Richard F. Macko, MD; Larry W. Forrester, PhD

  2. Aim • Use impedance-controlled ankle robot (anklebot) to determine whether lower-limb robotic training would be enhanced with overt rewards and augmented feedback. • Relevance • Robotics is rapidly emerging as viable approach to enhanced motor recovery after disabling stroke. • No prior studies have established explicitly whether reward improves rate/efficacy of robotics-assisted rehabilitation or produces neurophysiological adaptations associated with motor learning.

  3. Method • Clinical pilot (3 wk, 9 sessions): • 10 people with chronic hemiparetic stroke. • Randomly assigned to high reward or low reward conditions. • Training sessions (1 h): • Seated video game using paretic ankle to hit moving targets with anklebot providing assistance only as needed. • Assessments: • Paretic ankle motor control. • Learning curves. • Electroencephalography (EEG) coherence and spectral power during unassisted trials. • Gait function.

  4. Results • Both groups: • Changes in EEG. • High reward group: • Faster learning curves. • Smoother movements. • Reduced contralesional-frontoparietal coherence. • Reduced left-temporal spectral power. • Increased nonparetic step length.

  5. Conclusion • Combining explicit rewards with novel anklebot training may accelerate motor learning for restoring mobility.

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