OtherJournal of neuroengineering and rehabilitation2023

A robot-aided visuomotor wrist training induces motor and proprioceptive learning that transfers to the untrained ipsilateral elbow.

Huiying Zhu, Yizhao Wang, Naveen Elangovan and 4 others

PMID 37875916

WHAT IT FOUND

Fifteen healthy adults improved wrist position sense and untrained pointing after 45 min robot wrist training.

Gains also appeared in the untrained elbow. At 24 hours, elbow position sense remained improved, but pointing gains faded.

Key findings

01During training, mean cumulative spatial error fell from 106.3 deg*s in the first ten trials to 41.4 deg*s in the last ten, and mean movement time fell from 22.0 s to 17.8 s.

02At the trained wrist, mean JND fell from 1.26° to 0.88° (30% decrease), and untrained pointing error fell from 2.22° to 1.77° (20% decrease).

03In the untrained elbow, JND fell from 1.96° to 1.28° (35% decrease), and pointing error fell from 1.56° to 1.25° (20% decrease); at 24 hours elbow JND was still 23% lower than pretest, but elbow pointing error rose from 1.25° to 1.51°.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study tested 15 healthy young right-handed adults, not people with injury, neurological disease or functional complaints. There was no control or sham training group, so changes cannot be separated from repeated testing or natural fluctuation. The main outcomes were laboratory measures of position sense and pointing error, not everyday arm function, strength, pain, or clinical goals. Training was a single 45 min session, and retention was tested only at 24 h, so longer-term effects are unknown. One wrist movement-accuracy outlier was removed. Some retention analyses were not significant at the group level, although individual participants retained gains. The authors' suggestion that this may inform neurorehabilitation training is not tested in this paper.

Declared interests

The supplied text does not report a conflicts-of-interest or funding declaration. The metadata lists research support from a non-U.S. government source.

The easy way to misread this

Do not conclude that a short wrist robot training session will produce lasting elbow motor learning in patients. The study used 15 healthy adults, measured laboratory pointing and position sense, and elbow pointing gains had significantly decayed by 24 hours.

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The study

Participants
15 right-handed healthy adults; one wrist movement-accuracy outlier was removed for retention analysis
Certainty of evidence
Low

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    Huiying Zhu, Yizhao Wang, Naveen Elangovan, et al. A robot-aided visuomotor wrist training induces motor and proprioceptive learning that transfers to the untrained ipsilateral elbow. Journal of neuroengineering and rehabilitation. 2023.

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