Optimizing Hand Rehabilitation Post-Stroke Using Interactive Virtual Environments
Condition: Cerebrovascular Accident; Hemiparesis; Hemiplegia
MeSH terms: Stroke; Hemiplegia; Paresis
Study type: Interventional
Phase: Phase 1

Summary: 
      The complexity of sensorimotor control required for hand function as well as the wide range
      of recovery of manipulative abilities makes rehabilitation of the hand most challenging. The
      investigators past work has shown that training in a virtual environment (VE) using
      repetitive, adaptive algorithms has the potential to be an effective rehabilitation medium to
      facilitate motor recovery of hand function. These findings are in accordance with current
      neuroscience literature in animals and motor control literature in humans. The investigators
      are now in a position to refine and optimize elements of the training paradigms to enhance
      neuroplasticity. The investigators first aim tests if and how competition among body parts
      for neural representations stifles functional gains from different types of training
      regimens. The second aim tests the functional benefits of unilateral versus bilateral
      training regimens.The third aim tests whether functional improvements gained from training in
      a virtual environment transfer to other (untrained) skills in the real world.
    

Detailed description: 
      The complexity of sensorimotor control required for hand function as well as the wide range
      of recovery of manipulative abilities makes rehabilitation of the hand most challenging. The
      investigators past work has shown that training in a virtual environment (VE) using
      repetitive, adaptive algorithms has the potential to be an effective rehabilitation medium to
      facilitate motor recovery of hand function. These findings are in accordance with current
      neuroscience literature in animals and motor control literature in humans. The investigators
      are now in a position to refine and optimize elements of the training paradigms to enhance
      neuroplasticity. The investigators first aim tests if and how competition among body parts
      for neural representations stifles functional gains from different types of training
      regimens. The second aim tests the functional benefits of unilateral versus bilateral
      training regimens.The third aim tests whether functional improvements gained from training in
      a virtual environment transfer to other (untrained) skills in the real world.
    

Intervention name(s): HAS Training; HAT training; Bimanual Training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Robotically measured and facilitated training of the hemiparetic hand and arm in isolation, in a three dimensional haptically rendered virtual environment.; Robotically measured and facilitated training of the hemiparetic hand and arm as an integrated functional unit, in a three dimensional haptically rendered virtual environment; Robotically measured and facilitated training of the hemiparetic hand and non-hemiparetic hand together, in a three dimensional haptically rendered virtual environment
Other intervention name(s): Isolated UE training; Integrated UE training; Bilateral UE training
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cerebrovascular Accident; Robotics; Virtual Reality; Rehabilitation; Neuroplasticity