Robotically Augmented Mental Practice for Neuromotor Facilitation

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SUMMARY Upper limb motor function is often impaired due to neurologic injuries such as stroke and spinal cord injury. The ultimate objective is to innovate effective motor rehabilitation for enhancing clinical outcomes in stroke populations by discovering and applying scientific mechanisms and developing new engineering technologies to facilitate neuromotor adaptation. In stroke rehabilitation, mental practice, such as motor imagery and action observation, is a very effective intervention when performed appropriately. The challenge is that performance quality and efficacy of mental practice are highly variable and can be compromised. It is hypothesized that control and observation of robotic grasp and release actions via synergistic proximal muscle activation will increase neuromotor excitability of the non-activated distal muscles and hand function due to cognitive engagement with the externally present and visible robotic prosthesis. The Specific Aim of this proof of concept and feasibility study is to develop and test robotically augmented mental practice with synergistic proximal muscles for neuromotor facilitation of hand muscles. A robotically augmented mental practice will be developed for individuals to grasp and release an object by controlling the associated actions of a sound- generating robotic prosthesis utilizing surface electromyography (EMG) of shoulder/trunk muscles with deep learning algorithms. To demonstrate the proof of concept of increased neuromotor excitability and hand performance in able-bodied adults, transcranial magnetic stimulation will be applied to the motor cortex for the non-activated hand muscles and reaction time and maximal voluntary contraction performances will be tested with a finger in various practice conditions. The feasibility and possible trends in stroke survivors with upper extremity disabilities will also be examined. The project will be performed at the Georgia Institute of Technology by an interdisciplinary team of experts in fields directly related to the study: an applied physiologist, mechanical and biomedical engineers, a physical therapist, and a clinical neuroscientist. The successful completion of the study will provide augmented mental practice for neuromotor facilitation for distal muscles, and evidence for efficacy will be provided in able-bodied adults and feasibility in post-stroke individuals. The results will lead to the development of a more effective priming intervention before physical practice that can facilitate functional improvement as part of stroke rehabilitation.