Our Research

Portable Robotic-Assisted Constraint Induced Therapy in Stroke (PRACTiS)

Principal Investigators

Principal Investigator:
Corwin Boake, Ph.D., University of Texas Health Science Center at Houston

Co-Principal Investigators:
Eduardo M. Castillo, Ph.D., University of Texas Health Science Center at Houston
Gerard E. Francisco, M.D., University of Texas Health Science Center at Houston;Mission Connect scientist
Harvey S. Levin, Ph.D., Baylor College of Medicine; Mission Connect scientist
Marcia O’Malley, Ph.D., Rice University
Andrew C. Papanicolaou, Ph.D., University of Texas Health Science Center at Houston; Mission Connect scientist

Funding Agency

Mission Connect

Description of the Project

The objective of this project is to investigate a new stroke rehabilitation therapy protocol for impaired upper-extremity motor control. The therapy protocol developed in our laboratory integrates robotic-assisted activities with traditional constraint-induced movement therapy. Ourpilot study found that the therapy protocol produced improvement in motor control and evidence of cerebral reorganization as measured by magnetoencephalography (MEG). We also observed improvement in new measures of motor coordination (trajectory accuracy and minimum jerk speed profile correlation). In related research we have observed a relationship between motor recovery and preservation of the affected corticospinal tract as measured by diffusion tensor imaging (DTI). The proposed study will achieve the specific aims of;

• (1) verify the behavioral improvement from robot-assisted therapy by comparison with a control condition;
• (2) investigate the neurophysiological mechanisms that mediate behavioral change produced by this therapy; and
• (3) investigate the effect of therapy on newly developed measures of motor coordination.
  
  

Subjects will be adults with chronic (> 6 months) unilateral stroke causing hemiparesis with partial preservation of finger and wrist movement. The therapy protocol will require 3 days per week for 4 weeks, plus wearing a mitt constraint during 6 waking hours. At baseline, all subjects will undergo motor testing, DTI and MEG motor mapping during a hand-grasp activation task. Motor testing and MEG motor mapping will be repeated at 1 and 2 months after baseline. Pre- to post-therapy changes in MEG motor maps will be compared with behavioral motor improvement over the same interval. Therapeutic improvement will be evaluated with standard and novel motor coordination measures, and will be compared with corticospinal tract integrity at baseline. The results will have clinical impact by validating a form of therapy that is potentially more accessible and cost-efficient than conventional therapy. The results should also have theoretical value by clarifying neurophysiologic mechanisms of therapeutic gains.

Site

The research sites are the University of Texas Health Science Center at Houston, Rice University, Baylor College of Medicine

Timeline

In the 2007-2008 year, we are completing Year 1 of the 2-year project. 

Additional Resources

• http://publicaffairs.uth.tmc.edu/media/newsreleases/nr2008/robotic-device.htm
• http://www.examinernews.com/articles/2007/12/14/river_oaks/community/comm07.txt

For More Information

Nuray Yozbatiran, Ph.D., Project Coordinator
University of Texas Health Science Center-Houston
713-797-7589
Nuray.Yozbatiran@uth.tmc.edu