Retraining reaching in chronic stroke with real-time auditory feedback.

Stroke is the third leading cause of death in the United States. The aim of the present study was to enhance the motor recovery of patients in the chronic stroke period by means of upper extremity trajectory modification through real-time auditory feedback. A system of hardware, software, and feedback algorithms was developed. Two groups of patients in the chronic stroke period were trained on the system, one with practice and feedback and one with practice alone. Twenty reach parameters were defined and analyzed for differences between the first and last training sessions, between adaptation and learning trials, and among three targets. This study demonstrated that modification of the reach trajectory can be accomplished during the chronic stroke period either with practice alone or through practice accompanied by auditory feedback. However, improved path performance requires auditory feedback training, and cannot be achieved by practice alone.