Clinical Features to Predict the Use of a sEMG Wearable Device (REMO®) for Hand Motor Training of Stroke Patients: A Cross-Sectional Cohort Study

Abstract

After stroke, upper limb motor impairment is one of the most common consequences that compromises the level of the autonomy of patients. In a neurorehabilitation setting, the implementation of wearable sensors provides new possibilities for enhancing hand motor recovery. In our study, we tested an innovative wearable (REMO®) that detected the residual surface-electromyography of forearm muscles to control a rehabilitative PC interface. The aim of this study was to define the clinical features of stroke survivors able to perform ten, five, or no hand movements for rehabilitation training. 117 stroke patients were tested: 65% of patients were able to control ten movements, 19% of patients could control nine to one movement, and 16% could control no movements. Results indicated that mild upper limb motor impairment (Fugl-Meyer Upper Extremity ≥ 18 points) predicted the control of ten movements and no flexor carpi muscle spasticity predicted the control of five movements. Finally, severe impairment of upper limb motor function (Fugl-Meyer Upper Extremity > 10 points) combined with no pain and no restrictions of upper limb joints predicted the control of at least one movement. In conclusion, the residual motor function, pain and joints restriction, and spasticity at the upper limb are the most important clinical features to use for a wearable REMO® for hand rehabilitation training.

Prediction of rehabilitation induced motor recovery after stroke using a multi-dimensional and multi-modal approach

“…Number of repetitions, type of exercises could be settled by the physiotherapist according to clinical judgment and patient’s needs, tailoring difficulties on patient’s ability. All the technology-based modalities reported are included in the hospital clinical pathways and have been developed and validated through the institutional translational research projects funded by the Italian Ministry of Health and the European Commission, as described in previous publications ( Beghi et al, 2018 ; Rimini et al, 2020 ; Baldan et al, 2021 ; Luque-Moreno et al, 2021 ; Salvalaggio et al, 2022 ; Pregnolato et al, 2023 ).…”