Developing an Assessment and Rehabilitation System for Improving Bilateral Ankle Coordination Control and Functional Performances of Lower Limbs Following Chronic Stroke

Coordination movements of bilateral limbs for the ankle joints are very critical for daily activities. Stroke leads to impaired function of the paretic ankle joint, affecting coordination performance of bilateral ankle joints and decreasing ambulatory ability. However, there is little known about the bilateral feet coordination control for stroke patients, and there are few studies that have developed the appropriate rehabilitation program combining bilateral movement and visual feedback to improve impaired coordination for bilateral ankle joints and functional activities of lower limbs. Objectives:The specific aims of this proposal are the following: (1) to establish a bilateral ankle coordination control assessment system, demonstrating the validity and reliability and analyzing the differences of bilateral ankle joints; (2) to analyze the difference and gait performances between age-matched healthy adults and stroke subjects; (3) to develop a rehabilitation system with visual feedback and bilateral exercise by investigating the effects of this system on the motor recovery of paretic ankle joint and coordination performance of bilateral ankle joints in stroke patients.Methods:The first year of this proposal will establish and validate the bilateral ankle coordination control assessment system with an operation interface written in LabVIEW for measuring coordination control of the bilateral ankle joints. We will recruit 31 healthy subjects and evaluate the changes in coordination control of the bilateral ankle joints. The second year of this proposal will recruit 57 stroke adults and age-matched 57 healthy people, analyzing the differences in the coordination control of the bilateral ankle joints and gait performance. The clinical motor and functional assessments will be evaluated in the paretic lower limb for stroke subjects, including Fugl-Meyer Assessment, Motor Assessment Score, Berg Balance Scale, Time Up and Go and Barthel Index. The third year of this proposal will establish a rehabilitation system by combining the visual feedback and bilateral movement rehabilitation programs. 48 stroke subjects will be recruited and randomized to visual feedback group and traditional rehabilitation group, and the visual feedback training effects of using this rehabilitation system for 4 weeks on the functional recovery and coordination improvement of paretic ankle joint in stroke patients will be investigated.