Modifying upper-limb inter-joint coordination in healthy subjects by training with a robotic exoskeleton.
Tommaso Proietti, Emmanuel Guigon, Agnès Roby-Brami and 1 others
PMID 28606179WHAT IT FOUND
In healthy people, an arm exoskeleton that pushed joints into an unnatural pattern changed their arm coordination.
After the push stopped, most kept altered coordination for at least 30 minutes. It did not teach the intended pattern, and no patients or function were tested.
Key findings
01After the exoskeleton stopped applying the force field, most participants still moved with altered arm joint coordination, and this was visible after a 30-minute rest.
02The training did not make participants move in the exact coordination pattern the robot was trying to impose.
03Altered coordination also appeared on reaching targets that were never exposed to the force field.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only healthy people were tested, so it does not show what happens in stroke or other patients. The outcomes were lab measures of arm joint angles and hand paths, not pain, strength, independence, or daily activities. There was no untreated control group or comparison therapy, so the study cannot show clinical benefit. The robot had fixed joint lengths and the target distance was not adjusted for each person's height, which may have affected how they moved. Arm motion was measured only by the exoskeleton's own sensors, with a wrist splint limiting wrist movement, so real unassisted arm movement may differ. The number of wash-out movements was not always enough to tell how long the effects would last. Participants' awareness of the force field was not measured with a questionnaire.
Declared interests
The supplied text does not include a funding or conflict-of-interest statement.
The easy way to misread this
Do not read this as evidence that robotic exoskeleton training improves arm function in patients. The study used healthy people, not patients, and measured only lab reaching patterns. It found changes in joint coordination after the force field, but not that the desired coordination was learned or that daily tasks improved.