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

Chen, Hui-Ya (2006)
Ph.D. thesis, University of Birmingham.

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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:Ph.D. thesis.
Supervisor(s):Wing, Alan M.
School/Faculty:Schools (1998 to 2008) > School of Psychology
Department:Psychology
Keywords:balance, postural response, timing, predictive, reactive, hemiparetic stroke, assessment, rehabilitation
Subjects:BF Psychology
QP Physiology
Institution:University of Birmingham
Library Catalogue:Check for printed version of this thesis
ID Code:109
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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