Date of Award

December 2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Engineering

First Advisor

Na Jin Seo

Committee Members

Kurt Beschorner, Wilkistar Otieno, Schmit Brian, Wang Inga

Keywords

Biomechanics, Hand Grip, Sensation Deficit, Stroke, Vibrotactile Noise

Abstract

Many individuals experience hand impairment after stroke leading to decreased ability to perform daily living activities. Previous research studies have investigated how stroke survivors' pinch grip control differs from healthy individuals, even though many individuals can only grasp with power grip after stroke. Furthermore, many stroke survivors experience tactile sensory deficit in their paretic limb in addition to motor deficit. It is currently unknown how stroke induced tactile sensory deficit affects power grip force directional control, which is important in terms of preventing object slippage and power grip normal force generation. Additionally it is unknown if power grip could be improved through tactile sensory enhancement. This dissertation investigated how stroke survivors' power grip force control is different from healthy individuals. Also, the effect of stroke induced tactile sensory deficit on power grip force control and the benefits of a sensory enhancement method using remote subsensory vibrotactile noise on power grip phalanx force deviation was assessed. In addition, the effect of noise on the tactile sensation for stroke survivors with tactile sensory deficit and their performance on two dynamic gripping tasks, the Box and Block Test (`BBT', number of blocks moved in 60 seconds) and the Nine Hole Peg Test (`NHPT', time to pick up, place, and remove 9 pegs from 9 holes), were investigated. The theoretical framework of this dissertation is that tactile sensation is critical for grip control and impairment or enhancement of tactile sensation impacts power grip force control post stroke. Results showed that stroke survivors, especially those with tactile sensory deficit, gripped with increased phalanx force deviation compared to healthy individuals, showing reduced directional force control and increasing their chances of dropping objects. Remote subsensory vibrotactile noise improved fingertip and upper palm tactile sensation for stroke survivors with tactile sensory deficit. The noise also improved phalanx force directional control during power grip (reducing phalanx force deviation) for stroke survivors with and without tactile sensory deficit and age-matched healthy controls and improved the BBT score and time to complete the NHPT for stroke survivors with tactile sensory deficit. Overall, stroke survivors, particularly those with tactile sensory deficit, appear to have reduced phalanx force control during power grip, which may biomechanically result from a muscle activation pattern. Remote subsensory vibrotactile noise may have enhanced tactile sensation and hand motor control via stochastic resonance and interneuronal connections and could have potential as a wearable rehabilitation device for stroke survivors. This dissertation contributes to the long term goal of increasing stroke survivors' independence in completing daily living activities.

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