Aim

1. Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke Ronald N. Goodman, PhD; Jeremy C. Rietschel, PhD; Anindo Roy, PhD; Brian C. Jung, BS; Jason Diaz, MS; Richard F. Macko, MD; Larry W. Forrester, PhD

2. Aim • Use impedance-controlled ankle robot (anklebot) to determine whether lower-limb robotic training would be enhanced with overt rewards and augmented feedback. • Relevance • Robotics is rapidly emerging as viable approach to enhanced motor recovery after disabling stroke. • No prior studies have established explicitly whether reward improves rate/efficacy of robotics-assisted rehabilitation or produces neurophysiological adaptations associated with motor learning.

3. Method • Clinical pilot (3 wk, 9 sessions): • 10 people with chronic hemiparetic stroke. • Randomly assigned to high reward or low reward conditions. • Training sessions (1 h): • Seated video game using paretic ankle to hit moving targets with anklebot providing assistance only as needed. • Assessments: • Paretic ankle motor control. • Learning curves. • Electroencephalography (EEG) coherence and spectral power during unassisted trials. • Gait function.

4. Results • Both groups: • Changes in EEG. • High reward group: • Faster learning curves. • Smoother movements. • Reduced contralesional-frontoparietal coherence. • Reduced left-temporal spectral power. • Increased nonparetic step length.

5. Conclusion • Combining explicit rewards with novel anklebot training may accelerate motor learning for restoring mobility.