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Startle Distinguishes Task Expertise

Description

Recently, it was demonstrated that startle-evoked-movements (SEMs) are present during individuated finger movements (index finger abduction), but only following intense training. This demonstrates that changes in motor planning, which occur through training (motor learning - a characteristic which can provide researchers and clinicians with information about overall rehabilitative effectiveness), can…

Recently, it was demonstrated that startle-evoked-movements (SEMs) are present during individuated finger movements (index finger abduction), but only following intense training. This demonstrates that changes in motor planning, which occur through training (motor learning - a characteristic which can provide researchers and clinicians with information about overall rehabilitative effectiveness), can be analyzed with SEM. The objective here was to determine if SEM is a sensitive enough tool for differentiating expertise (task solidification) in a common everyday task (typing). If proven to be true, SEM may then be useful during rehabilitation for time-stamping when task-specific expertise has occurred, and possibly even when the sufficient dosage of motor training (although not tested here) has been delivered following impairment. It was hypothesized that SEM would be present for all fingers of an expert population, but no fingers of a non-expert population. A total of 9 expert (75.2 ± 9.8 WPM) and 8 non-expert typists, (41.6 ± 8.2 WPM) with right handed dominance and with no previous neurological or current upper extremity impairment were evaluated. SEM was robustly present (all p < 0.05) in all fingers of the experts (except the middle) and absent in all fingers of non-experts except the little (although less robust). Taken together, these results indicate that SEM is a measurable behavioral indicator of motor learning and that it is sensitive to task expertise, opening it for potential clinical utility.

ContributorsBartels, Brandon Michael (Author) / Honeycutt, Claire F (Thesis advisor) / Schaefer, Sydney (Committee member) / Santello, Marco (Committee member) / Arizona State University (Publisher)

Created2018

Relationship between Motor Generalization and Motor Transfer

Description

Adapting to one novel condition of a motor task has been shown to generalize to other naïve conditions (i.e., motor generalization). In contrast, learning one task affects the proficiency of another task that is altogether different (i.e. motor transfer). Much more is known about motor generalization than about motor transfer,…

Adapting to one novel condition of a motor task has been shown to generalize to other naïve conditions (i.e., motor generalization). In contrast, learning one task affects the proficiency of another task that is altogether different (i.e. motor transfer). Much more is known about motor generalization than about motor transfer, despite of decades of behavioral evidence. Moreover, motor generalization is studied as a probe to understanding how movements in any novel situations are affected by previous experiences. Thus, one could assume that mechanisms underlying transfer from trained to untrained tasks may be same as the ones known to be underlying motor generalization. However, the direct relationship between transfer and generalization has not yet been shown, thereby limiting the assumption that transfer and generalization rely on the same mechanisms. The purpose of this study was to test whether there is a relationship between motor generalization and motor transfer. To date, ten healthy young adult subjects were scored on their motor generalization ability and motor transfer ability on various upper extremity tasks. Although our current sample size is too small to clearly identify whether there is a relationship between generalization and transfer, Pearson product-moment correlation results and a priori power analysis suggest that a significant relationship will be observed with an increased sample size by 30%. If so, this would suggest that the mechanisms of transfer may be similar to those of motor generalization.

ContributorsSohani, Priyanka (Author) / Schaefer, Sydney (Thesis advisor) / Daliri, Ayoub (Committee member) / Honeycutt, Claire (Committee member) / Arizona State University (Publisher)

Created2018

Startle-evoked movement in multi-jointed, two-dimensional reaching tasks

Description

Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed…

Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed with difficulty. While the presence of SEM in the stroke survivor population advances scientific understanding of movement capabilities following a stroke, published studies using the SEM phenomenon only examined one joint. The ability of SEM to generate multi-jointed movements is understudied and consequently limits SEM as a potential therapy tool. In order to apply SEM as a therapy tool however, the biomechanics of the arm in multi-jointed movement planning and execution must be better understood. Thus, the objective of our study was to evaluate if SEM could elicit multi-joint reaching movements that were accurate in an unrestrained, two-dimensional workspace. Data was collected from ten subjects with no previous neck, arm, or brain injury. Each subject performed a reaching task to five Targets that were equally spaced in a semi-circle to create a two-dimensional workspace. The subject reached to each Target following a sequence of two non-startling acoustic stimuli cues: "Get Ready" and "Go". A loud acoustic stimuli was randomly substituted for the "Go" cue. We hypothesized that SEM is accessible and accurate for unrestricted multi-jointed reaching tasks in a functional workspace and is therefore independent of movement direction. Our results found that SEM is possible in all five Target directions. The probability of evoking SEM and the movement kinematics (i.e. total movement time, linear deviation, average velocity) to each Target are not statistically different. Thus, we conclude that SEM is possible in a functional workspace and is not dependent on where arm stability is maximized. Moreover, coordinated preparation and storage of a multi-jointed movement is indeed possible.

ContributorsOssanna, Meilin Ryan (Author) / Honeycutt, Claire (Thesis director) / Schaefer, Sydney (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)

Created2016-12

Effects of Trigeminal Nerve Stimulation on Visuomotor Learning

Description

A current thrust in neurorehabilitation research involves exogenous neuromodulation of peripheral nerves to enhance neuroplasticity and maximize recovery of function. This dissertation presents the results of four experiments aimed at assessing the effects of trigeminal nerve stimulation (TNS) and occipital nerve stimulation (ONS) on motor learning, which was behaviorally characterized…

A current thrust in neurorehabilitation research involves exogenous neuromodulation of peripheral nerves to enhance neuroplasticity and maximize recovery of function. This dissertation presents the results of four experiments aimed at assessing the effects of trigeminal nerve stimulation (TNS) and occipital nerve stimulation (ONS) on motor learning, which was behaviorally characterized using an upper extremity visuomotor adaptation paradigm. In Aim 1a, the effects of offline TNS using clinically tested frequencies (120 and 60 Hz) were characterized. Sixty-three participants (22.75±4.6 y/o), performed a visuomotor rotation task and received TNS before encountering rotation of hand visual feedback. In Aim 1b, TNS at 3 kHz, which has been shown to be more tolerable at higher current intensities, was evaluated in 42 additional subjects (23.4±4.6 y/o). Results indicated that 3 kHz stimulation accelerated learning while 60 Hz stimulation slowed learning, suggesting a frequency-dependent effect on learning. In Aim 2, the effect of online TNS using 120 and 60 Hz were characterized to determine if this protocol would deliver better outcomes. Sixty-three participants (23.2±3.9 y/o) received either TNS or sham concurrently with perturbed visual feedback. Results showed no significant differences among groups. However, a cross-study comparison of results obtained with 60 Hz offline TNS showed a statistically significant improvement in learning rates with online stimulation relative to offline, suggesting a timing-dependent effect on learning. In Aim 3, TNS and ONS were compared using the best protocol from previous aims (offline 3 kHz). Additionally, concurrent stimulation of both nerves was explored to look for potential synergistic effects. Eighty-four participants (22.9±3.2 y/o) were assigned to one of four groups: TNS, ONS, TNS+ONS, and sham. Visual inspection of learning curves revealed that the ONS group demonstrated the fastest learning among groups. However, statistical analyses did not confirm this observation. In addition, the TNS+ONS group appeared to learn faster than the sham and TNS groups but slower than the ONS only group, suggesting no synergistic effects using this protocol, as initially hypothesized. The results provide new information on the potential use of TNS and ONS in neurorehabilitation and performance enhancement in the motor domain.

ContributorsArias, Diego (Author) / Buneo, Christopher (Thesis advisor) / Schaefer, Sydney (Committee member) / Helms-Tillery, Stephen (Committee member) / Santello, Marco (Committee member) / Kleim, Jeffrey (Committee member) / Arizona State University (Publisher)

Created2023

A Systematic Review of Racial Inclusivity in Stroke Rehabilitation Research

Description

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every…

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every four minutes in the United States. While all Americans are gravely affected by this statistic, Black Americans are at a significantly increased risk of first stroke incidence when compared to their white counterparts, majorly due to heightened prevalence of stroke risk factors. Not only does race contribute as a factor in stroke incidence, but it also has a considerable impact in the physical impairment of Black Americans following stroke occurrence. While it still remains unclear as to whether or not stroke plays a significant role in stroke rehabilitation efforts, there is a clearly demonstrated need for increased reporting or participation of Black Americans in stroke rehabilitation clinical trials to have the ability to conduct a systematic review of these racial disparities in the near future. In the analysis of 36 stroke rehabilitation-related clinical research studies, 80% of selected trials failed to report any participant racial demographics, with 77.3% of the NIH-funded trials not reporting, as well. Out of the 7 trials that did provide some sort of participant racial information, only 5 successfully provided statistically significant racial data compared to the remainder that simply categorized participants’ race as “white” or “other.” In order to fully investigate the effects of race on stroke rehabilitation, it is imperative that researchers collect and report equally distributed and diverse participant racial data when publishing clinical research. Potential methods of improvement for researchers to include more racially diverse subject populations include more comprehensive and in-depth advertising and recruitment strategies for their studies. Research Methods: In order to produce accurate analyses of the current state of the relationship between race and stroke rehabilitation efforts, 36 stroke rehabilitation clinical research trials from various locations across the United States were identified using the Centralized Open-Access Rehabilitation Database for Stroke (SCOAR). These trials were evaluated in order to extract relevant data, such as number of trial participants, average age of participants, if the research trial was funded by the National Institute of Health (NIH) or not, and any reported participant racial demographic details. Trends across these categories were compared between all trials to determine if any disparities existed in providing data sufficient to support the relationship between varying racial populations and stroke rehabilitation efforts. Future Project Efforts: Future efforts will include the completion of submitting a Point of View/Directions for Research article for publication to offer an opportunity for clinical and basic researchers to examine the discrepancies surrounding racial inclusivity in stroke rehabilitation clinical research. The aim is to improve the ability of clinicians to interpret the literature, translate research studies into practices, and better direct future experiments. Further identification of stroke rehabilitation clinical research trials will be necessary, as well as modifications to current written work content.

ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

A Systematic Review of Racial Inclusivity in Stroke Rehabilitation Research

Description

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every…

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every four minutes in the United States. While all Americans are gravely affected by this statistic, Black Americans are at a significantly increased risk of first stroke incidence when compared to their white counterparts, majorly due to heightened prevalence of stroke risk factors. Not only does race contribute as a factor in stroke incidence, but it also has a considerable impact in the physical impairment of Black Americans following stroke occurrence. While it still remains unclear as to whether or not stroke plays a significant role in stroke rehabilitation efforts, there is a clearly demonstrated need for increased reporting or participation of Black Americans in stroke rehabilitation clinical trials to have the ability to conduct a systematic review of these racial disparities in the near future. In the analysis of 36 stroke rehabilitation-related clinical research studies, 80% of selected trials failed to report any participant racial demographics, with 77.3% of the NIH-funded trials not reporting, as well. Out of the 7 trials that did provide some sort of participant racial information, only 5 successfully provided statistically significant racial data compared to the remainder that simply categorized participants’ race as “white” or “other.” In order to fully investigate the effects of race on stroke rehabilitation, it is imperative that researchers collect and report equally distributed and diverse participant racial data when publishing clinical research. Potential methods of improvement for researchers to include more racially diverse subject populations include more comprehensive and in-depth advertising and recruitment strategies for their studies. Research Methods: In order to produce accurate analyses of the current state of the relationship between race and stroke rehabilitation efforts, 36 stroke rehabilitation clinical research trials from various locations across the United States were identified using the Centralized Open-Access Rehabilitation Database for Stroke (SCOAR). These trials were evaluated in order to extract relevant data, such as number of trial participants, average age of participants, if the research trial was funded by the National Institute of Health (NIH) or not, and any reported participant racial demographic details. Trends across these categories were compared between all trials to determine if any disparities existed in providing data sufficient to support the relationship between varying racial populations and stroke rehabilitation efforts. Future Project Efforts: Future efforts will include the completion of submitting a Point of View/Directions for Research article for publication to offer an opportunity for clinical and basic researchers to examine the discrepancies surrounding racial inclusivity in stroke rehabilitation clinical research. The aim is to improve the ability of clinicians to interpret the literature, translate research studies into practices, and better direct future experiments. Further identification of stroke rehabilitation clinical research trials will be necessary, as well as modifications to current written work content.

ContributorsMcNally, Mikayla (Author) / Beeler, Adeline (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Watts College of Public Service & Community Solut (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

She Said I Love You: The Effect of StartReact and Startle Adjuvant Rehabilitation Therapy in Post-Stroke Aphasia, Apraxia, and Dysarthria of Speech

Description

Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally…

Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally significant changes in individuals with severe post- stroke aphasia remains a key challenge for the rehabilitation community. This dissertation aimed to evaluate the efficacy of Startle Adjuvant Rehabilitation Therapy (START), a tele-enabled, low- cost treatment, to improve quality of life and speech in individuals with severe-to-moderate stroke. START is the exposure to startling acoustic stimuli during practice of motor tasks in individuals with stroke. START increases the speed and intensity of practice in severely impaired post-stroke reaching, with START eliciting muscle activity 2-3 times higher than maximum voluntary contraction. Voluntary reaching distance, onset, and final accuracy increased after a session of START, suggesting a rehabilitative effect. However, START has not been evaluated during impaired speech. The objective of this study is to determine if impaired speech can be elicited by startling acoustic stimuli, and if three days of START training can enhance clinical measures of moderate to severe post-stroke aphasia and apraxia of speech. This dissertation evaluates START in 42 individuals with post-stroke speech impairment via telehealth in a Phase 0 clinical trial. Results suggest that impaired speech can be elicited by startling acoustic stimuli and that START benefits individuals with severe-to-moderate post-stroke impairments in both linguistic and motor speech domains. This fills an important gap in aphasia care, as many speech therapies remain ineffective and financially inaccessible for patients with severe deficits. START is effective, remotely delivered, and may likely serve as an affordable adjuvant to traditional therapy for those that have poor access to quality care.

ContributorsSwann, Zoe Elisabeth (Author) / Honeycutt, Claire F (Thesis advisor) / Daliri, Ayoub (Committee member) / Rogalsky, Corianne (Committee member) / Liss, Julie (Committee member) / Schaefer, Sydney (Committee member) / Arizona State University (Publisher)

Created2022

Exploring the Utilization of Startle as a Therapy Tool in Individuals with Stroke

Description

Stroke is a debilitating disorder and 75% of individuals with stroke (iwS) have upper extremity deficits. IwS are prescribed therapies to enhance upper-extremity mobility, but current most effective therapies have minimum requirements that the individuals with severe impairment do not meet. Thus, there is a need to enhance the therapies.…

Stroke is a debilitating disorder and 75% of individuals with stroke (iwS) have upper extremity deficits. IwS are prescribed therapies to enhance upper-extremity mobility, but current most effective therapies have minimum requirements that the individuals with severe impairment do not meet. Thus, there is a need to enhance the therapies. Recent studies have shown that StartReact -the involuntary release of a planned movement, triggered by a startling stimulus (e.g., loud sound)- elicits faster and larger muscle activation in iwS compared to voluntary-initiated movement. However, StartReact has been only cursorily studied to date and there are some gaps in the StartReact knowledge. Previous studies have only evaluated StartReact on single-jointed movements in iwS, ignoring more functional tasks. IwS usually have abnormal flexor activity during extension tasks and abnormal muscle synergy especially during multi-jointed tasks; therefore, it is unknown 1) if more complex multi-jointed reach movements are susceptible to StartReact, and 2) if StartReact multi-jointed movements will be enhanced in the same way as single-jointed movements in iwS. In addition, previous studies showed that individuals with severe stroke, especially those with higher spasticity, experienced higher abnormal flexor muscle activation during StartReact trials. However, there is no study evaluating the impact of this elevated abnormal flexor activity on movement, muscle activation and muscle synergy alterations during voluntary-initiated movements after exposure to StartReact.
This dissertation evaluates StartReact and the voluntary trials before and after exposure to StartReact during a point-to-point multi-jointed reach task to three different targets covering a large workspace. The results show that multi-jointed reach tasks are susceptible to StartReact in iwS and the distance, muscle and movement onset speed, and muscle activations percentages and amplitude increase during StartReact trials. In addition, the distance, accuracy, muscle and movement onsets speeds, and muscle synergy similarity indices to the norm synergies increase during the voluntary-initiated trials after exposure to StartReact. Overall, this dissertation shows that exposure to StartReact did not impair voluntary-initiated movement and muscle synergy, but even improved them. Therefore, this study suggests that StartReact is safe for more investigations in training studies and therapy.

ContributorsRahimiTouranposhti, Marziye (Author) / Honeycutt, Claire F. (Thesis advisor) / Roh, Jinsook (Committee member) / Berman, Spring (Committee member) / Lee, Hyunglae (Committee member) / Marvi, Hamid (Committee member) / Schaefer, Sydney (Committee member) / Arizona State University (Publisher)

Created2020

beeler_fall_2021.pdf

ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

beeler-mcnally_fall-2021_thesis-defense-presentation.pdf

ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

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