Quantifying learned non-use after stroke using unilateral and bilateral steering tasks

Learned non-use (LNU) is common after stroke and manifests when persons with stroke spontaneously use their stronger less-impaired arm despite residual functional abilities in the impaired arm. This tendency of under utilizing the impaired arm slows down the re-acquisition of bilateral coordination on activities of daily living. We wanted to examine whether this behavior could be studied and quantified using the TheraDrive system, a low-cost, mechatronic/robotic stroke rehabilitation system which uses a commercial force-feedback steering wheel along with custom games and unilateral and bilateral steering tasks for therapy and assessment. We attempt to quantify the role of the impaired arm in bilateral tracking with one and two-wheeled modes of the TheraDrive. Our results indicate that impaired arm use, arm bias and learned non-use behaviors may best be detected in decoupled bilateral tracking tasks.