Investigating cross-education in multiple sclerosis following upper limb robotic rehabilitation

The overall goal of this thesis was to develop an adaptive rehabilitation technique using a haptic wrist robotic device that would induce the phenomenon of cross-education to improve upper limb function. Following a literature review, Chapter 4 provides a scoping review of existing literature surrounding rehabilitation robots for MS. Chapter 5 reports the development and rationale of the rehabilitative approach, to develop an algorithm that is individualized and adaptive to the user. Once the algorithm was developed, an eight-week intervention for fourteen individuals with MS and eight non-affected adults was conducted. The purpose of the intervention was two-fold and presented in Chapter 6, to improve overall wrist and grip strength (assessed via maximal grip and isometric wrist strength) and Chapter 7, to improve overall motor control (assessed via robotic performance measures). Lastly, in both chapters, cross-over effects of strength and motor control to the untrained limb were evaluated. Results of this eight-week training reported increases in wrist strength for the MS group with an average percent change score across all muscle directions of 62.59% in the trained limb and 53.26% in the untrained limb. The control group also reported an average percent change of 31.31% in strength in the trained limb and 24.26% in the untrained limb. MS participants significantly decreased in tracking and figural error (degree of error) post-intervention suggesting evidence that motor control adaptations are possible following an adaptive and resistive robotic intervention of the upper limb. Following the results of the eight-week intervention, Chapter 9 was to investigate changes in strength and motor control following four-weeks of training in an additional subgroup of participants following the same rehabilitative protocol. Results demonstrate a clinically meaningful improvement in strength of the trained limb, but no significant improvements in figural or tracking error performance – suggestive that robotic rehabilitation of this kind needs to be longer in duration than four-weeks to elicit meaningful adaptations of motor control.

Name thesis:degree_name

Ph.D. Applied Health Sciences

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Faculty of Applied Health Sciences

Department dc:contributor.department

Applied Health Sciences Program

Grantor

Brock University

Year dc:date.issued

2024

Author dc:creator

• Mannella, Kailynn

• robotic rehabilitation
• multiple sclerosis
• cross-education
• upper limb
• neuroplasticity

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/10464/18898

OAI identifier oai:identifier

oai:brocku.scholaris.ca:10464/18898