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Parkinson's disease (PD) is a neurodegenerative disorder that produces a characteristic set of neuromotor deficits that sometimes includes reduced amplitude and velocity of movement. Several studies have shown that people with PD improved their motor performance when presented with external cues. Other work has demonstrated that high velocity

Parkinson's disease (PD) is a neurodegenerative disorder that produces a characteristic set of neuromotor deficits that sometimes includes reduced amplitude and velocity of movement. Several studies have shown that people with PD improved their motor performance when presented with external cues. Other work has demonstrated that high velocity and large amplitude exercises can increase the amplitude and velocity of movement in simple carryover tasks in the upper and lower extremities. Although the cause for these effects is not known, improvements due to cueing suggest that part of the neuromotor deficit in PD is in the integration of sensory feedback to produce motor commands. Previous studies have documented some somatosensory deficits, but only limited information is available regarding the nature and magnitude of sensorimotor deficits in the shoulder of people with PD. The goals of this research were to characterize the sensorimotor impairment in the shoulder joint of people with PD and to investigate the use of visual feedback and large amplitude/high velocity exercises to target PD-related motor deficits. Two systems were designed and developed to use visual feedback to assess the ability of participants to accurately adjust limb placement or limb movement velocity and to encourage improvements in performance of these tasks. Each system was tested on participants with PD, age-matched control subjects and young control subjects to characterize and compare limb placement and velocity control capabilities. Results demonstrated that participants with PD were less accurate at placing their limbs than age-matched or young control subjects, but that their performance improved over the course of the test session such that by the end, the participants with PD performed as well as controls. For the limb velocity feedback task, participants with PD and age-matched control subjects were less accurate than young control subjects, but at the end of the session, participants with PD and age-matched control subjects were as accurate as the young control subjects. This study demonstrates that people with PD were able to improve their movement patterns based on visual feedback of performance and suggests that this feedback paradigm may be useful in exercise programs for people with PD.
ContributorsSmith, Catherine (Author) / Abbas, James J (Thesis advisor) / Ingalls, Todd (Thesis advisor) / Krishnamurthi, Narayanan (Committee member) / Buneo, Christopher (Committee member) / Rikakis, Thanassis (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Robotic rehabilitation for upper limb post-stroke recovery is a developing technology. However, there are major issues in the implementation of this type of rehabilitation, issues which decrease efficacy. Two of the major solutions currently being explored to the upper limb post-stroke rehabilitation problem are the use of socially assistive rehabilitative

Robotic rehabilitation for upper limb post-stroke recovery is a developing technology. However, there are major issues in the implementation of this type of rehabilitation, issues which decrease efficacy. Two of the major solutions currently being explored to the upper limb post-stroke rehabilitation problem are the use of socially assistive rehabilitative robots, robots which directly interact with patients, and the use of exoskeleton-based systems of rehabilitation. While there is great promise in both of these techniques, they currently lack sufficient efficacy to objectively justify their costs. The overall efficacy to both of these techniques is about the same as conventional therapy, yet each has higher overhead costs that conventional therapy does. However there are associated long-term cost savings in each case, meaning that the actual current viability of either of these techniques is somewhat nebulous. In both cases, the problems which decrease technique viability are largely related to joint action, the interaction between robot and human in completing specific tasks, and issues in robot adaptability that make joint action difficult. As such, the largest part of current research into rehabilitative robotics aims to make robots behave in more "human-like" manners or to bypass the joint action problem entirely.
ContributorsRamakrishna, Vijay Kambhampati (Author) / Helms Tillery, Stephen (Thesis director) / Buneo, Christopher (Committee member) / Barrett, The Honors College (Contributor) / Economics Program in CLAS (Contributor) / W. P. Carey School of Business (Contributor) / School of Life Sciences (Contributor)
Created2015-05
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Description
Repetitive practice of functional movement patterns during motor rehabilitation are known to drive learning (or relearning) of novel motor skills, but the learning process is highly variable between individuals such that responsiveness to task-specific training is often patient-specific. A number of neuroimaging and neurophysiological methods have been proposed to better

Repetitive practice of functional movement patterns during motor rehabilitation are known to drive learning (or relearning) of novel motor skills, but the learning process is highly variable between individuals such that responsiveness to task-specific training is often patient-specific. A number of neuroimaging and neurophysiological methods have been proposed to better predict a patient’s responsiveness to a given type or dose of motor therapy. However, these methods are often time- and resource-intensive, and yield results that are not readily interpretable by clinicians. In contrast, standardized visuospatial tests may offer a more feasible solution. The work presented in this dissertation demonstrate that a clinical paper-and-pencil test of visuospatial function may improve predictive models of motor skill learning in older adults and individuals with stroke pathology. To further our understanding of the neuroanatomical correlates underlying this behavioral relationship, I collected diffusion-weighted magnetic resonance images from 19 nondemented older adults to determine if diffusion characteristics of white matter tracts explain shared variance in delayed visuospatial memory test scores and motor skill learning. Consistent with previous work, results indicated that the structural integrity of regions with the bilateral anterior thalamic radiations, corticospinal tracts, and superior longitudinal fasciculi are related to delayed visuospatial memory performance and one-week skill retention. Overall, results of this dissertation suggest that incorporating a clinical paper-and-pencil test of delayed visuospatial memory may prognose motor rehabilitation outcomes and support that personalized variables should be considered in standards of care. Moreover, regions within specific white matter tracts may underlie this behavioral relationship and future work should investigate these regions as potential targets for therapeutic intervention.
ContributorsLingo VanGilder, Jennapher (Author) / Schaefer, Sydney Y (Thesis advisor) / Santello, Marco (Committee member) / Buneo, Christopher (Committee member) / Rogalsky, Corianne (Committee member) / Duff, Kevin (Committee member) / Arizona State University (Publisher)
Created2021
Description

Neuromodulation is an emerging field of research that has a proven therapeutic benefit on a number of neurological disorders, including epilepsy and stroke. It is characterized by using exogenous stimulation to modify neural activity. Prior studies have shown the positive effect of non-invasive trigeminal nerve stimulation (TNS) on motor learning.

Neuromodulation is an emerging field of research that has a proven therapeutic benefit on a number of neurological disorders, including epilepsy and stroke. It is characterized by using exogenous stimulation to modify neural activity. Prior studies have shown the positive effect of non-invasive trigeminal nerve stimulation (TNS) on motor learning. However, few studies have explored the effect of this specific neuromodulatory method on the underlying physiological processes, including heart rate variability (HRV), facial skin temperatures, skin conductance level, and respiratory rate. Here we present preliminary results of the effects of 3kHz supraorbital TNS on HRV using non-linear (Poincaré plot descriptors) and time-domain (SDNN) measures of analysis. Twenty-one (21) healthy adult subjects were randomly assigned to 2 groups: 3kHz Active stimulation (n=11) and Sham (n=10). Participants’ physiological markers were monitored continuously across three blocks: one ten-minute baseline block, one twenty-minute treatment block, and one ten-minute recovery block. TNS targeting the ophthalmic branches of the trigeminal nerve was delivered during the treatment block for twenty minutes in 30 sec. ON/OFF cycles. The active stimulation group exhibited larger values of all Poincaré descriptors and SDNN during blocks two and three, signifying increased HRV and autonomic nervous system activity.

ContributorsParmar, Romir (Author) / Buneo, Christopher (Thesis director) / Helms Tillery, Stephen (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / Dean, W.P. Carey School of Business (Contributor)
Created2023-05