Duchenne muscular Dystrophy (DMD) is a progressive degenerative muscle disease, affecting, among others, the upper extremities. Effective hand rehabilitation can improve the hand function of people with DMD. To reach this goal, we first need to gain more insight into the hand cognitive-motor performance of people with DMD. This is the first study employing a systematic analysis on multi-finger, cognitive-motor performance of people with DMD. For this purpose, we propose an active dynamic visuo-motor task. The task employed six visual stimuli, a subset of which was activated at each trial. The stimuli were activated with a frequency of 1, 2, 3 and 4 Hz. Eight healthy participants and three participants with DMD performed the task. Additionally, the healthy participants performed seven sessions, and we assessed the training effects. Task-related cognitive-motor performance was evaluated using information transfer rate (ITR) and perceived workload. Regarding ITR, healthy participants performed significantly better than DMD participants; however, this was more evident for trials involving more than three fingers. Workload showed no difference between the healthy and the DMD groups. Healthy participants significantly improved their performance during training. Our results suggest that hand rehabilitation of people with DMD should consider multi-finger dynamic training. However, additional research with more people with DMD is needed for further generalization of our conclusions.
Duchenne muscular Dystrophy (DMD) Is a progressive muscle degenerative disease. Active hand assistive devices, can improve the quality of life of people with DMD. Such devices show a rejection rate due to complexity. Our hypothesis is, that a simple orthosis might prove more functional and realistic in assisting people with DMD. To investigate, we developed a portable setup that provides various visual stimuli and records the response of the subjects' fingers through a mouse clicking task. Six LEDs served as visual stimuli. The subjects' responses were obtained through mechanical interaction with two vertical mice. Different combinations of frequencies and numbers of stimuli were tested with 8 healthy subjects and one with DMD. Performance was evaluated in terms of information transfer rate (ITR), pattern accuracy and perceived workload. The outcome shows that lower complexity results in lower ITR and lower workload for all subjects. While for healthy subjects, maximum ITR was 4.3 bits/s, for DMD maximum ITR was 2.5 bits/s. Both maxima were achieved at the same trial (3 fingers at 2 Hz). This trial agrees with a pareto optimization analysis of ITR with respect to workload. The results support our hypothesis for a simple yet functional solution. Furthermore healthy subjects and the individual with DMD, in principal show similar finger control, albeit with lower absolute performance.
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