http://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-017-0245-y
- Wei Rong,
- Waiming Li,
- Mankit Pang,
- Junyan Hu,
- Xijun Wei,
- Bibo Yang,
- Honwah Wai,
- Xiaoxiang Zheng and
- Xiaoling HuEmail authorView ORCID ID profile
Journal of NeuroEngineering and Rehabilitation201714:34
DOI: 10.1186/s12984-017-0245-y
© The Author(s). 2017
Received: 9 June 2016
Accepted: 14 April 2017
Published: 26 April 2017
Abstract
Background
It is a challenge to reduce
the muscular discoordination in the paretic upper limb after stroke in
the traditional rehabilitation programs.
Method
In this study, a neuromuscular
electrical stimulation (NMES) and robot hybrid system was developed for
multi-joint coordinated upper limb physical training. The system could
assist the elbow, wrist and fingers to conduct arm reaching out, hand
opening/grasping and arm withdrawing by tracking an indicative moving
cursor on the screen of a computer, with the support from the joint
motors and electrical stimulations on target muscles, under the
voluntary intention control by electromyography (EMG). Subjects with
chronic stroke (n = 11)
were recruited for the investigation on the assistive capability of the
NMES-robot and the evaluation of the rehabilitation effectiveness
through a 20-session device assisted upper limb training.
Results
In the evaluation, the
movement accuracy measured by the root mean squared error (RMSE) during
the tracking was significantly improved with the support from both the
robot and NMES, in comparison with those without the assistance from the
system (P < 0.05). The
intra-joint and inter-joint muscular co-contractions measured by EMG
were significantly released when the NMES was applied to the agonist
muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P
< 0.05) were captured by the clinical scores, i.e., Modified Ashworth
Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA),
Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT).
Conclusions
The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers.
Trial registration
ClinicalTrials.gov. NCT02117089; date of registration: April 10, 2014
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