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Influence of stroke location on heart rate variability in robot-assistive neurorehabilitation

Authors: Herbert F. Jelinek; Katherine G. August; Md. Hasan Imam; Kinda Khalaf; Alexander Koenig; Robert Riener; Marimuthu Palaniswami; +1 Authors

Influence of stroke location on heart rate variability in robot-assistive neurorehabilitation

Abstract

Active mental engagement and a positive emotional state are prerequisites for optimal outcomes of rehabilitation programs for stroke patients. Our program at the ETH, Zurich utilizes a closed loop response in automated robot-assist gait training coupled with virtual reality provided tasks. Heart rate variability has been shown to be sensitive to cognitive as well as emotional states as well as pathophysiological-environmental challenges. We investigated whether adaptation to a task differs between stroke patients with either cortical or subcortical lesions. Seven non-stroke control participants were compared to responses of nine stroke patients with either a diagnosis of cortical or subcortical stroke using heart rate variability. The robot-assist virtual reality training session consisted of a familiarization period, a baseline walking period, an under-challenged, appropriate challenged and over-challenged condition. Time and frequency domain as well as nonlinear features were assessed. Our results indicated that only entropy was sensitive to identifying adaptation to a different level of difficulty. Thus a significant difference was seen between the three stroke groups and control for adaption from baseline to the under-challenged condition (p=0.026), and also from the under-challenged condition to an appropriate level of challenge (p=0.027). We propose that the entropy feature provides a robust index of cognitive and emotional level associated with task difficulty experienced by post-stroke patients that allows real time closed loop regulation of robot-assist gait rehabilitation.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
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