Design of novel timing paradigms for investigation and rehabilitation of predictive and reactive postural response for hemiparetic stroke

Chen, Hui-Ya (2006). Design of novel timing paradigms for investigation and rehabilitation of predictive and reactive postural response for hemiparetic stroke. University of Birmingham. Ph.D.

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Abstract

Timing is a crucial aspect of dynamic tasks, and understanding of timing effects in balance control may contribute to refine balance retraining paradigms for hemiparetic stroke. This thesis opens with a review on predictive and reactive modes of balance control. The initial review concludes there is unexplored potential in predictive setting of timing in imposed balance and in reactive adjustment of timing in self-perturbed balance. This leads to introduction and development of two paradigms by group studies. The first paradigm increases timing certainty of imposed force perturbations by using a regular metronome. Experiments indicate the effect of predictive control on reducing prolonged response time of hemiparetic stroke. The second paradigm introduces temporal metronome error to self-produced postural perturbations that are made in synchrony with the metronome. Experiments show deteriorated reactive control of timing due to increased biomechanical constraint in maintaining balance, but the potential of hemiparetic patients to adjust movement timing is also noted. Effects of these two paradigms in retraining hemiparetic balance are tested by single case studies. The first evidences training potential of predictive control to speed up responses. The second demonstrates training effect of timing cues in re-adjusting the asymmetric pattern between motions of two sides of the body. In conclusion, the paradigms of this thesis provide new means for examining timing effects of predictive and reactive postural responses. Empirical results encourage further development of balance retraining paradigms for hemiparetic stroke with an emphasis on timing, and so potential RCT designs are outlined.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

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