Journal of NeuroEngineering and Rehabilitation (Sep 2023)

Autonomy support encourages use of more-affected arm post-stroke

  • Sujin Kim,
  • Yumi Shin,
  • Yeonwoo Jeong,
  • Seungyoung Na,
  • Cheol E. Han

DOI
https://doi.org/10.1186/s12984-023-01238-0
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 14

Abstract

Read online

Abstract Background Autonomy support, which involves providing individuals the ability to control their own behavior, is associated with improved motor control and learning in various populations in clinical and non-clinical settings. This study aimed to investigate whether autonomy support combined with an information technology (IT) device facilitated success in using the more-affected arm during training in individuals with stroke. Consequently, we examined whether increased success influenced the use of the more-affected arm in mild to moderate subacute to chronic stroke survivors. Methods Twenty-six participants with stroke were assigned to the autonomy support or control groups. Over a 5-week period, training and test sessions were conducted using the Individualized Motivation Enhancement System (IMES), a device developed specifically for this study. In the autonomy support group, participants were able to adjust the task difficulty parameter, which controlled the time limit for reaching targets. The control group did not receive this option. The evaluation of the more-affected arm's use, performance, and impairment was conducted through clinical tests and the IMES. These data were then analyzed using mixed-effect models. Results In the IMES test, both groups showed a significant improvement in performance (p 0.05). However only the autonomy support group demonstrated a significant increase in the use of the more-affected arm following the training (p 0.05). Also, in the autonomy support group, the increase in the use of the more-affected arm was associated with the increase in the successful experience significantly (p = 0.007). Conclusions Combining autonomy support with an IT device is a practical approach for enhancing performance and promoting the use of the more-affected upper extremity post-stroke. Autonomy support facilitates the successful use of the more-affected arm, thereby increasing awareness of the training goal of maximizing its use. Trial registration The study was registered retrospectively with the Clinical Research Information Service (KCT0008117; January 13, 2023; https://cris.nih.go.kr/cris/search/detailSearch.do/23875 ).

Keywords