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Author Notes:

Correspondence should be addressed to Andrew J. Butler. andrew.john.butler@emory.edu

Andrew J. Butler and Maysam Ghovanloo participated in the design of the study.

Stephen N. Housley, David Wu, and Andrew J. Butler collected and analyzed all data and drafted the manuscript.

All authors contributed to the interpretation of the results.

All authors edited the manuscript.

All authors read and approved the final manuscript.

The content is solely the responsibility of the authors and does not necessarily represent the official view of the funder.

The datasets supporting the conclusions of this article are available in the FigShare repository at https://figshare.com/s/8d5a9a29057629a529d2 and https://figshare.com/s/d54f97b79dd0e05231bd.


Research Funding:

The work was supported by the National Center for Advancing Translational Sciences of the National Institute of Health (NIH) under Award no. UL1TR000454.

Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation


Journal Title:

Stroke Research and Treatment


Volume 2017


, Pages 3603860-3603860

Type of Work:

Article | Final Publisher PDF


Stroke is a leading cause of long-Term disability around the world. Many survivors experience upper extremity (UE) impairment with few rehabilitation opportunities, secondary to a lack of voluntary muscle control. We developed a novel rehabilitation paradigm (TDS-HM) that uses a Tongue Drive System (TDS) to control a UE robotic device (Hand Mentor: HM) while engaging with an interactive user interface. In this study, six stroke survivors with moderate to severe UE impairment completed 15 two-hour sessions of TDS-HM training over five weeks. Participants were instructed to move their paretic arm, with synchronized tongue commands to track a target waveform while using visual feedback to make accurate movements. Following TDS-HM training, significant improvements in tracking performance translated into improvements in the UE portion of the Fugl-Meyer Motor Assessment, range of motion, and all subscores for the Stroke Impact Scale. Regression modeling found daily training time to be a significant predictor of decreases in tracking error, indicating the presence of a potential dose-response relationship. The results of this pilot study indicate that the TDS-HM system can elicit significant improvements in moderate to severely impaired stroke survivors. This pilot study gives preliminary insight into the volume of treatment time required to improve outcomes.

Copyright information:

© 2017 Stephen N. Housley et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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