Reaching Performance in Heathy Individuals and Stroke Survivors Improves after Practice with Vibrotactile State Feedback
Date of Award
Doctor of Philosophy (PhD)
Scheidt, Robert A.
Mrotek, Leigh A.
Stroke causes deficits of cognition, motor, and/or somatosensory functions. These deficits degrade the capability to perform activities of daily living (ADLs). Many research investigations have focused on mitigating the motor deficits of stroke through motor rehabilitation. However, somatosensory deficits are common and may contribute importantly to impairments in the control of functional arm movement. This dissertation advances the goal of promoting functional motor recovery after stroke by investigating the use of a vibrotactile feedback (VTF) body-machine interface (BMI). The VTF BMI is intended to improve control of the contralesional arm of stroke survivors by delivering supplemental limb-state feedback to the ipsilesional arm, where somatosensory feedback remains intact. To develop and utilize a VTF BMI, we first investigated how vibrotactile stimuli delivered on the arm are perceived and discriminated. We determined that stimuli are better perceived sequentially than those delivered simultaneously. Such stimuli can propagate up to 8 cm from the delivery site, so future applications should consider adequate spacing between stimulation sites. We applied these findings to create a multi-channel VTF interface to guide the arm in the absence of vision. In healthy people, we found that short-term practice, less than 2.5 hrs, allows for small improvements in the accuracy of horizontal planar reaching. Long-term practice, about 10 hrs, engages motor learning such that the accuracy and efficiency of reaching is improved and cognitive loading of VTF-guided reaching is reduced. During practice, participants adopted a movement strategy whereby BMI feedback changed in just one channel at a time. From this observation, we sought to develop a practice paradigm that might improve stroke survivors’ learning of VTF-guided reaching without vision. We investigated the effects of practice methods (whole practice vs part practice) in stroke survivors’ capability to make VTF-guided arm movements. Stroke survivors were able to improve the accuracy of VTF-guided reaching with practice, however there was no inherent differences between practice methods. In conclusion, practice on VTF-guided 2D reaching can be used by healthy people and stroke survivors. Future studies should investigate long-term practice in stroke survivors and their capability to use VTF BMIs to improve performance of unconstrained actions, including ADLs.