Combined Transcranial Direct Current Stimulation and Virtual Reality-Based Paradigm for Upper Limb Rehabilitation in Individuals with Restricted Movements. A Feasibility Study with a Chronic Stroke Survivor with Severe Hemiparesis

[EN] Impairments of the upper limb function are a major cause of disability and rehabilitation. Most of the available therapeutic options are based on active exercises and on motor and attentional inclusion of the affected arm in task oriented movements. However, active movements may not be possible...

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Detalhes bibliográficos
Autores: Fuentes Calderón, María Antonia, Latorre Grau, Jorge, Colomer Font, Carolina, Sánchez-Ledesma, María José, Noé-Sebastián, Enrique, Borrego, Adrián|||0000-0001-5134-7811, Alcañiz Raya, Mariano Luis|||0000-0001-9207-0636, Llorens Rodríguez, Roberto|||0000-0002-8677-8707
Formato: artículo
Fecha de publicación:2018
País:España
Recursos:Universitat Politècnica de València (UPV)
Repositorio:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Idioma:inglés
OAI Identifier:oai:riunet.upv.es:10251/140845
Acesso em linha:https://riunet.upv.es/handle/10251/140845
Access Level:acceso abierto
Palavra-chave:Virtual reality
TDCS
Eye-tracking
Surface electromyography
Upper limb paresis
Monoparesis, stroke
INGENIERIA TELEMATICA
EXPRESION GRAFICA EN LA INGENIERIA
TEORIA DE LA SEÑAL Y COMUNICACIONES
Descrição
Resumo:[EN] Impairments of the upper limb function are a major cause of disability and rehabilitation. Most of the available therapeutic options are based on active exercises and on motor and attentional inclusion of the affected arm in task oriented movements. However, active movements may not be possible after severe impairment of the upper limbs. Different techniques, such as mirror therapy, motor imagery, and non-invasive brain stimulation have been shown to elicit cortical activity in absence of movements, which could be used to preserve the available neural circuits and promote motor learning. We present a virtual reality-based paradigm for upper limb rehabilitation that allows for interaction of individuals with restricted movements from active responses triggered when they attempt to perform a movement. The experimental system also provides multisensory stimulation in the visual, auditory, and tactile channels, and transcranial direct current stimulation coherent to the observed movements. A feasibility study with a chronic stroke survivor with severe hemiparesis who seemed to reach a rehabilitation plateau after two years of its inclusion in a physical therapy program showed clinically meaningful improvement of the upper limb function after the experimental intervention and maintenance of gains in both the body function and activity. The experimental intervention also was reported to be usable and motivating. Although very preliminary, these results could highlight the potential of this intervention to promote functional recovery in severe impairments of the upper limb.