Influence of stroke location on heart rate variability in robot-assistive neurorehabilitation

Herbert F. Jelinek, Katherine G. August, Md Hasan Imam, Kinda Khalaf, Alexander Koenig, Robert Riener, Marimuthu Palaniswami, Ahsan H. Khandoker

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

3 Scopus citations


Active mental engagement and a positive emotional state are prerequisites for optimal outcomes of rehabilitation programs for stroke patients. Our program at the ETH, Zurich utilizes a closed loop response in automated robot-assist gait training coupled with virtual reality provided tasks. Heart rate variability has been shown to be sensitive to cognitive as well as emotional states as well as pathophysiological-environmental challenges. We investigated whether adaptation to a task differs between stroke patients with either cortical or subcortical lesions. Seven non-stroke control participants were compared to responses of nine stroke patients with either a diagnosis of cortical or subcortical stroke using heart rate variability. The robot-assist virtual reality training session consisted of a familiarization period, a baseline walking period, an under-challenged, appropriate challenged and over-challenged condition. Time and frequency domain as well as nonlinear features were assessed. Our results indicated that only entropy was sensitive to identifying adaptation to a different level of difficulty. Thus a significant difference was seen between the three stroke groups and control for adaption from baseline to the under-challenged condition (p=0.026), and also from the under-challenged condition to an appropriate level of challenge (p=0.027). We propose that the entropy feature provides a robust index of cognitive and emotional level associated with task difficulty experienced by post-stroke patients that allows real time closed loop regulation of robotassist gait rehabilitation.

Original languageBritish English
Title of host publication2014 Middle East Conference on Biomedical Engineering, MECBME 2014
PublisherIEEE Computer Society
Number of pages4
ISBN (Print)9781479947997
StatePublished - 2014
Event2014 2nd Middle East Conference on Biomedical Engineering, MECBME 2014 - Doha, Qatar
Duration: 17 Feb 201420 Feb 2014

Publication series

NameMiddle East Conference on Biomedical Engineering, MECBME
ISSN (Print)2165-4247
ISSN (Electronic)2165-4255


Conference2014 2nd Middle East Conference on Biomedical Engineering, MECBME 2014


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