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This algorithm outlines a structured, performance-based progressive training method conducted over six weeks for stroke rehabilitation. Target locations in a visuomotor task are customized to each subject's baseline active range of motion (AROM) for dorsiflexion and plantar flexion. The training difficulty increases through reduced robotic support and adjusted task challenges in response to prior performance. Feedback and sustained motivation are prioritized to enhance engagement and success rates, particularly during the critical early weeks of training.
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Figure 2. Algorithm used for performance-based progressive training over 6 wk training period. Target locations in visuomotor task are set at each subject’s baseline active range of motion (AROM) for both directions (dorsiflexion and plantar flexion). "Easy-to-difficult" sequence in terms of progressively decreasing robotic support, determined by stiffness setting: K (Nm/rad), is same for each visit throughout training, but task difficulty in terms of vertical location of targets (challenging AROM) and speed of targets (challenging speed of ankle targeting) on screen are adjusted in weeks 3–4 and 5–6, respectively, based on prior subject performance in order to provide challenge where applicable (at least sustained 80% targeting success without robotic assistance in weeks 1 and 2) and sustain subject motivation. Roy A, Forrester LW, Macko RF, Krebs HI. Changes in passive ankle stiffness and its effects on gait function in people with chronic stroke. J Rehabil Res Dev. 2013; 50(4):555–72.http://dx.doi.org/10.1682/JRRD.2011.10.0206 ResearcherID/ORCID: Anindo Roy, PhD: E-4312-2012
