Autonomy support encourages use of more-affected arm post-stroke

Journal of NeuroEngineering and Rehabilitation

Research

Cheol E. Han¹  Yeonwoo Jeong²  Sujin Kim²  Yumi Shin³  Seungyoung Na⁴ 

[1] Department of Electronics and Information Engineering, Korea University, Sejong, South Korea;Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, South Korea;Department of Physical Therapy, Jeonju University, Jeonju, South Korea;Department of Physical Therapy, Jeonju University, Jeonju, South Korea;Department of Rehabilitative and Assistive Technology, National Rehabilitation Center, Seoul, South Korea;Department of Rehabilitation and Medicine, Ongoul Rehabilitation Hospital, Jeonju, South Korea;

关键词: Choice behavior;    Hemiparesis;    Motivation;    Self-efficacy;    Upper extremity;   

DOI  :  10.1186/s12984-023-01238-0

 received in 2023-01-20, accepted in 2023-08-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAutonomy support, which involves providing individuals the ability to control their own behavior, is associated with improved motor control and learning in various populations in clinical and non-clinical settings. This study aimed to investigate whether autonomy support combined with an information technology (IT) device facilitated success in using the more-affected arm during training in individuals with stroke. Consequently, we examined whether increased success influenced the use of the more-affected arm in mild to moderate subacute to chronic stroke survivors.MethodsTwenty-six participants with stroke were assigned to the autonomy support or control groups. Over a 5-week period, training and test sessions were conducted using the Individualized Motivation Enhancement System (IMES), a device developed specifically for this study. In the autonomy support group, participants were able to adjust the task difficulty parameter, which controlled the time limit for reaching targets. The control group did not receive this option. The evaluation of the more-affected arm's use, performance, and impairment was conducted through clinical tests and the IMES. These data were then analyzed using mixed-effect models.ResultsIn the IMES test, both groups showed a significant improvement in performance (p < 0.0001) after the training period, without any significant intergroup differences (p > 0.05). However only the autonomy support group demonstrated a significant increase in the use of the more-affected arm following the training (p < 0.001). Additionally, during the training period, the autonomy support group showed a significant increase in successful experiences with using the more-affected arm (p < 0.0001), while the control group did not exhibit the same level of improvement (p > 0.05). Also, in the autonomy support group, the increase in the use of the more-affected arm was associated with the increase in the successful experience significantly (p = 0.007).ConclusionsCombining autonomy support with an IT device is a practical approach for enhancing performance and promoting the use of the more-affected upper extremity post-stroke. Autonomy support facilitates the successful use of the more-affected arm, thereby increasing awareness of the training goal of maximizing its use.Trial registrationThe study was registered retrospectively with the Clinical Research Information Service (KCT0008117; January 13, 2023; https://cris.nih.go.kr/cris/search/detailSearch.do/23875).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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