Error Augmented Robotic Rehabilitation of the Upper Limb - A Review <s> (no statistical analysis was performed <s> Feedback is an important element in motor learning during rehabilitation therapy following stroke. The objective of this pilot study was to better understand the effect of position feedback during task-oriented reach training of the upper limb in people with chronic stroke. Five subjects participated in the training for 30 minutes three times a week for 6 weeks. During training, subjects performed reaching movements over a predefined path. When deviation from this path occurred, shoulder and elbow joints received position feedback using restraining forces. We recorded the amount of position feedback used by each subject. During pre- and posttraining assessments, we collected data from clinical scales, isometric strength, and workspace of the arm. All subjects showed improvement on one or several kinematic variables during a circular motion task after training. One subject showed improvement on all clinical scales. Subjects required position feedback between 7.4% and 14.7% of training time. Although augmented feedback use was limited, kinematic outcome measures and movement performance during training increased in all subjects, which was comparable with other studies. Emphasis on movement errors at the moment they occur may possibly stimulate motor learning when movement tasks with sufficiently high levels of difficulty are applied. <s> BIB001 </s> Error Augmented Robotic Rehabilitation of the Upper Limb - A Review <s> (no statistical analysis was performed <s> To study the effects of different feedback error amplification methods on a subject's upper-limb motor learning and affect during a point-to-point reaching exercise, we developed a real-time controller for a robotic manipulandum. The reaching environment was visually distorted by implementing a thirty degrees rotation between the coordinate systems of the robot's end-effector and the visual display. Feedback error amplification was provided to subjects as they trained to learn reaching within the visually rotated environment. Error amplification was provided either visually or through both haptic and visual means, each method with two different amplification gains. Subjects' performance (i.e., trajectory error) and self-reports to a questionnaire were used to study the speed and amount of adaptation promoted by each error amplification method and subjects' emotional changes. We found that providing haptic and visual feedback promotes faster adaptation to the distortion and increases subjects' satisfaction with the task, leading to a higher level of attentiveness during the exercise. This finding can be used to design a novel exercise regimen, where alternating between error amplification methods is used to both increase a subject's motor learning and maintain a minimum level of motivational engagement in the exercise. In future experiments, we will test whether such exercise methods will lead to a faster learning time and greater motivation to pursue a therapy exercise regimen. <s> BIB002
• the two week treatment blocks might not be sufficient to provide any measurable change clinically, small number of subjects (five) is not sufficient to draw any definitive conclusion • control treatment, while not providing error-augmentation, still improved functionality • MS subjects adapt to unfamiliar dynamic environments • Improvements from error measures don't correlate with clinical measures • On average, subjects performed better in 1-week follow-up evaluations than they did at the end of the two weeks of training. It may be that the impaired nervous system does not react to nor does it try to learn from smaller errors, and the EA approach may promote learning by simply intensifying the signal-tonoise ratio for sensory systems, making errors more noticeable BIB001 • Four subjects improved on the FMA-UL by between 1.0 and 9.5 points. • MI, two subjects improved by 8 and 13 points each • Four subjects improved on the ARAT by between 0.5 and 5.0 points. • Three subjects increased workspace by between 20.2% -63.4% (no statistical analysis was performed) • Emphasis on errors at the moment they occur may possibly stimulate motor learning when patients perform movement tasks with sufficiently high difficulty levels. • Disturbing force affected significantly the movement outcomes in healthy but not in dystonic subjects • In the dystonic population the altered dynamic exposure seems to induce a subsequent improvement, i.e. a beneficial after-effect in terms of optimal path control, compared with the correspondent reference movement outcome (p = 0.05) • The short-time error-enhancing training in dystonia could represent an effective approach for motor performance improvement, since the exposure to controlled dynamic alterations induces a refining of the existing but strongly imprecise motor scheme and sensorimotor patterns. BIB002 error enhancing n/a Clinical: SelfAssessment Mankin questionnaire Kinematic: Absolute deviation of trajectory, mean of max deviation • Increased satisfaction and attentiveness in error augmented therapy and even more in visual and haptic mode (no p-values provided) • the means of each affect measure are significantly different between almost all pairs of conditions (p<0.05) • High-gain visual plus haptic EA leads to a significantly larger amount of learning a, in comparison with both of the visual EA methods (p<0.1) • Significant differences in effect (specifically: satisfaction, attentiveness and dominance) between progressively more exaggerated error amplification conditions, even when presented in random order to subject