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- Eye gaze patterns after stroke: correlates of a VR action execution and observation taskPublication . Alves, Júlio; Vourvopoulos, Athanasios; Bernardino, Alexandre; Bermúdez i Badia, SergiThe concept of a partially shared neural circuitry between action observation and action execution in healthy participants has been demonstrated through a number of studies. However, little research has been done in this regard utilizing eye movement metrics in rehabilitation contexts.In this study we approach action observation and action execution by combining a virtual environment and eye tracking technology. Participants consisted of stroke survivors, and were required to perform a simple reachand-grab and place-and-release task with both their paretic and non-paretic arm. Results showed congruency in gaze metrics between action execution and action observation, for distribution and duration of gaze events. Furthermore, in action observation, longer smooth pursuit segments were detected when observing the representation of the paretic arm, thus providing evidence that the affected circuitry may be activated during observation of the simulated action. These results can lead to novel rehabilitation methods using virtual reality technology.
- An assistive mobile platform for delivering knowledge of performance feedbackPublication . Neves, Davide; Vourvopoulos, Athanasios; Cameirão, Mónica S.; Bermúdez i Badia, SergiUpper limb motor deficits caused by stroke have a big impact on a person’s daily activities and independence. One strategy for promoting motor relearning consists on the delivery of meaningful feedback during rehabilitative training. In this paper we describe the development and first evaluation of a system that combines a portable arm orthosis device and a mobile application running on a tablet in order to provide knowledge of performance to stroke patients while performing therapy. Here we present preliminary results and discuss the potential of this technology.
- Clinical effects of immersive multimodal BCI-VR training after bilateral neuromodulation with rTMS on upper limb motor recovery after stroke. a study protocol for a randomized controlled trialPublication . Sánchez Cuesta, Francisco José; Arroyo-Ferrer, Aida; González-Zamorano, Yeray; Vourvopoulos, Athanasios; Bermúdez i Badia, Sergi; Figueiredo, Patricia; Serrano, José Ignacio; Romero, Juan PabloThe motor sequelae after a stroke are frequently persistent and cause a high degree of disability. Cortical ischemic or hemorrhagic strokes affecting the cortico spinal pathways are known to cause a reduction of cortical excitability in the lesioned area not only for the local connectivity impairment but also due to a contralateral hemisphere inhibitory action. Non-invasive brain stimulation using high frequency repetitive magnetic transcranial stimulation (rTMS) over the lesioned hemisphere and contralateral cortical inhibition using low-frequency rTMS have been shown to increase the excitability of the lesioned hemisphere. Mental representation techniques, neurofeedback, and virtual reality have also been shown to increase cortical excitability and complement conventional rehabilitation. Materials and Methods: We aim to carry out a single-blind, randomized, controlled trial aiming to study the efficacy of immersive multimodal Brain–Computer Interfacing-Virtual Reality (BCI-VR) training after bilateral neuromodulation with rTMS on upper limb motor recovery after subacute stroke (>3 months) compared to neuromodulation combined with conventional motor imagery tasks. This study will include 42 subjects in a randomized controlled trial design. The main expected outcomes are changes in the Motricity Index of the Arm (MI), dynamometry of the upper limb, score according to Fugl-Meyer for upper limb (FMA-UE), and changes in the Stroke Impact Scale (SIS). The evaluation will be carried out before the intervention, after each intervention and 15 days after the last session. Conclusions: This trial will show the additive value of VR immersive motor imagery as an adjuvant therapy combined with a known effective neuromodulation approach opening new perspectives for clinical rehabilitation protocols.
- Personalization of assistance and knowledge of performance feedback on a hybrid mobile and myo-electric robotic system for motor rehabilitation after strokePublication . Neves, Davide; Vourvopoulos, Athanasios; Cameirão, Mónica; Bermúdez i Badia, SergiUpper limb motor deficits caused by stroke have a large impact on a person’s daily activities and independence. The personalization of the rehabilitation tasks to the needs of the patient as well as the enhancement of the feedback provided to the patient are strategies for promoting motor relearning. In this paper we describe the development and pilot evaluation of a portable system that uses a robotic orthosis to deliver assistance and meaningful feedback during rehabilitative training. Two software modules are implemented, one that investigates an optimal calibration method for the personalization of the level of assistance, and another one that combines the orthosis with a mobile application running on a tablet that provides graphical knowledge of performance feedback to stroke patients while performing therapy. Here we present two preliminary studies and discuss the potential of this technology.