Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke

Mirror therapy (MT) facilitates motor learning and induces cortical reorganization and motor recovery from stroke. We applied the new digital mirror therapy (DMT) system to compare the cortical activation under the three visual feedback conditions: (1) no mirror visual feedback (NoMVF), (2) bilatera...

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Main Authors: Chao-Sheng Chang, Ying-Ying Lo, Chien-Liang Chen, Hsin-Min Lee, Wei-Chi Chiang, Ping-Chia Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-11-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fneur.2019.01227/full
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author Chao-Sheng Chang
Chao-Sheng Chang
Ying-Ying Lo
Chien-Liang Chen
Hsin-Min Lee
Wei-Chi Chiang
Ping-Chia Li
author_facet Chao-Sheng Chang
Chao-Sheng Chang
Ying-Ying Lo
Chien-Liang Chen
Hsin-Min Lee
Wei-Chi Chiang
Ping-Chia Li
author_sort Chao-Sheng Chang
collection DOAJ
description Mirror therapy (MT) facilitates motor learning and induces cortical reorganization and motor recovery from stroke. We applied the new digital mirror therapy (DMT) system to compare the cortical activation under the three visual feedback conditions: (1) no mirror visual feedback (NoMVF), (2) bilateral synchronized task-based mirror visual feedback training (BMVF), and (3) reciprocal task-based mirror visual feedback training (RMVF). During DMT, EEG recordings, including time-dependent event-related desynchronization (ERD) signal amplitude in both mu and beta bands, were obtained from the standard C3 (ispilesional hemisphere, IH), C4 (contralesional hemisphere, CH), and Cz scalp sites (supplementary motor area, SMA). The entire ERD curve was separated into three time-phases: P0 (−2 to 0 s), P1 (0 to 2 s), and P2 (2 to 4 s). Four-way and subsequent repeated-measures analyses of variance were used to examine the effects of group (stroke vs. control group), test condition (NoMVF, BMVF, and RMVF), time-phase (P0, P1, and P2), and brain area (IH, CH, SMA) on the ERD areas (%) in mu and beta bands. For the mu band, generally, ERD areas (%) were larger in the control than in the stroke group. The ERD areas (%) were largest under the RMVF condition, followed by BMVF and NoMVF conditions. Similar results were found in the beta bands. The main effects of group, time-phase, and test condition on the ERD areas (%) were significant for the three brain areas, except the main effect of group in the SMA (Cz) and CH (C4) brain area. The ERD areas (%) were larger in the control than in the stroke group. The ERD area (%) was significantly larger during P1 than during P0 and P2 (ps < 0.02), and during P2 than during P0 (ps < 0.01). The ERD area (%) under the RMVF condition was significantly larger than that under the BMVF condition and NoMVF condition (ps < 0.05). The present study suggests that cortical activation particularly in the SMA (Cz) of the brain increases in the RMVF condition in both healthy subjects and stroke patients. This result supports the hypothesis that stroke patients may benefit from RMVF training.
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spelling doaj.art-a9546ab7e46f402c987e673dc80916bb2022-12-21T18:52:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-11-011010.3389/fneur.2019.01227467625Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-strokeChao-Sheng Chang0Chao-Sheng Chang1Ying-Ying Lo2Chien-Liang Chen3Hsin-Min Lee4Wei-Chi Chiang5Ping-Chia Li6Department of Healthcare Administration, I-Shou University, Kaohsiung, TaiwanDepartment of Emergency Medicine, E-Da Hospital, Kaohsiung, TaiwanDepartment of Healthcare Administration, I-Shou University, Kaohsiung, TaiwanDepartment of Physical Therapy, I-Shou University, Kaohsiung, TaiwanDepartment of Physical Therapy, I-Shou University, Kaohsiung, TaiwanDepartment of Occupational Therapy, I-Shou University, Kaohsiung, TaiwanDepartment of Occupational Therapy, I-Shou University, Kaohsiung, TaiwanMirror therapy (MT) facilitates motor learning and induces cortical reorganization and motor recovery from stroke. We applied the new digital mirror therapy (DMT) system to compare the cortical activation under the three visual feedback conditions: (1) no mirror visual feedback (NoMVF), (2) bilateral synchronized task-based mirror visual feedback training (BMVF), and (3) reciprocal task-based mirror visual feedback training (RMVF). During DMT, EEG recordings, including time-dependent event-related desynchronization (ERD) signal amplitude in both mu and beta bands, were obtained from the standard C3 (ispilesional hemisphere, IH), C4 (contralesional hemisphere, CH), and Cz scalp sites (supplementary motor area, SMA). The entire ERD curve was separated into three time-phases: P0 (−2 to 0 s), P1 (0 to 2 s), and P2 (2 to 4 s). Four-way and subsequent repeated-measures analyses of variance were used to examine the effects of group (stroke vs. control group), test condition (NoMVF, BMVF, and RMVF), time-phase (P0, P1, and P2), and brain area (IH, CH, SMA) on the ERD areas (%) in mu and beta bands. For the mu band, generally, ERD areas (%) were larger in the control than in the stroke group. The ERD areas (%) were largest under the RMVF condition, followed by BMVF and NoMVF conditions. Similar results were found in the beta bands. The main effects of group, time-phase, and test condition on the ERD areas (%) were significant for the three brain areas, except the main effect of group in the SMA (Cz) and CH (C4) brain area. The ERD areas (%) were larger in the control than in the stroke group. The ERD area (%) was significantly larger during P1 than during P0 and P2 (ps < 0.02), and during P2 than during P0 (ps < 0.01). The ERD area (%) under the RMVF condition was significantly larger than that under the BMVF condition and NoMVF condition (ps < 0.05). The present study suggests that cortical activation particularly in the SMA (Cz) of the brain increases in the RMVF condition in both healthy subjects and stroke patients. This result supports the hypothesis that stroke patients may benefit from RMVF training.https://www.frontiersin.org/article/10.3389/fneur.2019.01227/fullmirror therapy systemoccupational therapypattern trainingsensorimotor trainingstroke therapy
spellingShingle Chao-Sheng Chang
Chao-Sheng Chang
Ying-Ying Lo
Chien-Liang Chen
Hsin-Min Lee
Wei-Chi Chiang
Ping-Chia Li
Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
Frontiers in Neurology
mirror therapy system
occupational therapy
pattern training
sensorimotor training
stroke therapy
title Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
title_full Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
title_fullStr Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
title_full_unstemmed Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
title_short Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke
title_sort alternative motor task based pattern training with a digital mirror therapy system enhances sensorimotor signal rhythms post stroke
topic mirror therapy system
occupational therapy
pattern training
sensorimotor training
stroke therapy
url https://www.frontiersin.org/article/10.3389/fneur.2019.01227/full
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