Scientific Publications

Impaired motor function after stroke is a major cause of disability in Americans. Both human and animal studies have established that the plasticity of the human brain plays an important role in motor recovery. For people who have experienced a stroke, it has been demonstrated that highly repetitive task specific exercise training can facilitate cortical plasticity in the brain, with concurrently improved motor abilities and enhanced functional activity performance. Scientific evidence also suggests that biofeedback and sensorimotor cues may benefit motor recovery.

Scientific publications are summarized as follows:

Neuroplasticity

Gowland C. Recovery of motor function following stroke: profile & predicators. Physiotherapy 1982;34:77-84.

Cramer SC, Nelles G, Benson RR, et al: A functional MRI study of subjects recovered from hemiparetic stroke. Stroke 1997;28:2518—27

Nudo RJ, Milliken GW: Reorganization of movement representations in primary motor cortex following focal ischemic infarcts in adult squirrel monkeys. J Neurophysiol 1996;75: 2144—9

Nudo RJ, Milliken GW, Jenkins WM, Merzenich MM: Use dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. J Neurosci 1996;16:785—807

Nudo RJ, Wise BM, SiFuentes F, Milliken GW: Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science 1996;272:1791—94

Repetitive Task Specific Exercise Training

Wolf SL, Winstein CJ, MillerJP, Taub E, Gitendra U, Morris D, Guiliani C, Light K, Nichols-Larsen D. Effect of Constraint-Induced Movement Therapy on Upper Extremity Function 3 to 9 Months After Stroke: The EXCITE Randomized Clinical Trial JAMA, November 1, 2006; 296: 2095 — 2104

Liepert J, Bauder H, Wolfgang HR, Miltner WH, Taub E,Weiller C: Treatment-induced cortical reorganization afterstroke in humans. Stroke 2000;31:1210—6

Levy CE, Nichols DS, Schmalbrock PM, Keller P, Chakeres DW: Functional MRI evidence of cortical reorganization in upper-limb stroke hemiplegia treated with constraintinduced movement therapy. Am J Phys Med Rehabil 2001; 80:4—12

Robotic aided Rehabilitation

Stein J., Narendran K., McBean J., Krebs K., Hughes, R. Electromyography-Controlled Exoskeletal Upper-Limb-Powered Orthosis for Exercise Training after Stroke. Am. J. Phys. Med. Rehabil. Vol. 86. No. 4. 2007

Aisen FL, Krebs HI, Hogan N, McDowell F, Volpe BT. The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke. Arch Neurol. 1997;54:443-446.

Fasoli SE, Krebs HI, Stein J, Frontera WR, Hogan N. Effects of robotic therapy on motor impairment and recovery in chronic stroke. Arch Phys Med Rehabil. 2003;84:477-482.

Lum PS, Burgar CG, Shor PC, Majmundar M, Van der Loos M. Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil. 2002;83:952-959.

Rohrer B, Fasoli S, Krebs HI, et al. Movement smoothness changes during stroke recovery. J Neurosci. 2002;22(18):8297-8304

Volpe BT, Krebs HI, Hogan N, Edelsteinn L, Diels CM, Aisen ML. Robot training enhanced motor outcome in patients with stroke maintained over 3 years. Neurology. 1999;53(8):1874-1876.

Biofeedback

Huang H, WolfSL, Jiping H. Recent developments in biofeedback for neuromotor rehabilitation. Journal of NeuroEngineering and Rehabilitation 2006, 3:11     doi:10.1186/1743-0003-3-11

Sveistrup H: Motor rehabilitation using virtual reality. J Neuroengineering Rehabil 2004, 1:10

WolfSL, Bulter AJ, Alberts JL Contemporary linkages between EMG, kinetics and stroke rehabilitation. J Electromyogr Kinesiol. 2005 June:15 (3) 229-39

Wolf SL, Binder-MacLeod SA. Electromyographic biofeedback applications to the hemiplegic patient. Changes in upper extremity neuromuscular and functional status. Phys Ther. 1983 Sep;63(9):1393-403.

Hilgard ER, Bower GH: Recent developments.
In Theories of learning. 4th edition. Englewood Cliffs, N.J.,, Prentice-Hall; 1975:550-605.

Sensorimotor

Ferraro M, Palazzolo JJ, Krol J, Krebs HI, Hogan N, Volpe BT. Robot-aided sensorimotor arm training improves outcome in patients with chronic stroke. Neurology. 2003;61:1604-1607.

Volpe BT, Krebs HI, Hogan N, Edelstein L, Diels C, Aisen M. A novel approach to stroke rehabilitation: robot-aided sensorimotor stimulation. Neurology. 2000;54(10):1938-1944.