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arXiv · 2511.00259

Tailored robotic training improves hand function and proprioceptive processing in stroke survivors with proprioceptive deficits: A randomized controlled trial

Andria J. Farrens·Luis Garcia-Fernandez·Raymond Diaz Rojas·Jillian Obeso Estrada·Dylan Reinsdorf·Vicky Chan·Disha Gupta·Joel Perry·Eric Wolbrecht·An Do·Steven C. Cramer·David J. Reinkensmeyer
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Abstract

Precision rehabilitation aims to tailor movement training to improve outcomes. We tested whether proprioceptively-tailored robotic training improves hand function and neural processing in stroke survivors. Using a robotic finger exoskeleton, we tested two proprioceptively-tailored approaches: Propriopixel Training, which uses robot-facilitated, gamified movements to enhance proprioceptive processing, and Virtual Assistance Training, which reduces robotic aid to increase reliance on self-generated feedback. In a randomized controlled trial, forty-six chronic stroke survivors completed nine 2-hour sessions of Standard, Propriopixel or Virtual training. Among participants with proprioceptive deficits, Propriopixel ((Box and Block Test: 7 +/- 4.2, p=0.002) and Virtual Assistance (4.5 +/- 4.4 , p=0.068) yielded greater gains in hand function (Standard: 0.8 +/- 2.3 blocks). Proprioceptive gains correlated with improvements in hand function. Tailored training enhanced neural sensitivity to proprioceptive cues, evidenced by a novel EEG biomarker, the proprioceptive Contingent Negative Variation. These findings support proprioceptively-tailored training as a pathway to precision neurorehabilitation.

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Andria J. Farrens, Luis Garcia-Fernandez, Raymond Diaz Rojas, Jillian Obeso Estrada, Dylan Reinsdorf, Vicky Chan, Disha Gupta, Joel Perry, Eric Wolbrecht, An Do, Steven C. Cramer, David J. Reinkensmeyer. 2025-10-31. Tailored robotic training improves hand function and proprioceptive processing in stroke survivors with proprioceptive deficits: A randomized controlled trial. https://arxiv.org/abs/2511.00259

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