Development of a Low-Cost, Modular Muscle–Computer Interface for At-Home Telerehabilitation for Chronic Stroke

Marin-Pardo, Octavio; Phanord, Coralie S.; Donnelly, Miranda R; Laine, Christopher M.; Liew, Sook‐Lei

doi:10.3390/s21051806

Cited by 15 publications

(29 citation statements)

References 34 publications

(32 reference statements)

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“…biofeedback [17] comparable with face-to-face therapy Hemiparesis/lower limb few studies; not represented primary objective; reviews [5,23] heterogeneous exercises favorable telerehabilitation results; low costs Aphasia comparative studies [28]; randomized controlled trials [29][30][31][32] various interventions controversial results…”

Section: Studies Exercises Resultsmentioning

confidence: 99%

“…The communication skills of therapists may be challenged in different ways from situations encountered during face-to-face rehabilitation, and their training in this field may be opportune. One study showed that the system used for TR motivated the patient if it reported their real-time progress to the therapist and permitted the latter's prompt and regular intervention [17]. Another benefit of the patient's constant contact with a therapist has been the improvement of the social isolation feeling and overall mood [12].…”

Section: Engagement and Motivation In Telerehabilitationmentioning

confidence: 99%

“…The continuous feedback of the therapist during in-clinic training of a spastic limb is missing during classical home training. The visual information provided by EMG or sensor assessment helps the patient to perform the movements correctly and efficiently while also increasing their motivation [6,17,47].…”

Section: Innovation In Telerehabilitationmentioning

confidence: 99%

“…Rehabilitation therapy has proven its efficacy when task-oriented and applied in large doses, intensively, with many repetitions and continuously, in order to facilitate relearning [7,12,17]. The results seem to be directly proportional to the training period [7,17]. For example, improvements of arm function have been obtained after sessions summing 3 h or more per week [10].…”

Section: Introductionmentioning

confidence: 99%

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Telerehabilitation—A Viable Option for the Recovery of Post-Stroke Patients

Ciortea

Motoașcă²,

Ungur

et al. 2021

Applied Sciences

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As the number of stroke survivors is continuously growing, with an important number suffering from consequent functional deficits, the rehabilitation field is facing more complex demands. Technological progress gives us the opportunity to remotely assist patients while they exercise at home through telerehabilitation (TR), addressing the problems of limited medical resources and staff, difficult transportation, or living a long distance from rehabilitation centers. In addition, TR is a way to provide continuity in long-term post-stroke recovery during the COVID-19 pandemic, which limits traveling and human interaction. While the implementation of TR is increasing, the biggest challenges are to raise patients’ acceptability of the new method and their motivation and engagement during the program. In this review, we aimed to find methods to address these challenges by identifying the patients who benefit the most from this therapy and efficiently organizing the space and technology used for telerehabilitation. User-friendly technologies and devices along with therapists’ constant support and feedback are some of the most important aspects that make TR an efficient intervention and an alternative to conventional therapy.

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Section: Studies Exercises Resultsmentioning

confidence: 99%

Section: Engagement and Motivation In Telerehabilitationmentioning

confidence: 99%

Section: Innovation In Telerehabilitationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Telerehabilitation—A Viable Option for the Recovery of Post-Stroke Patients

Ciortea

Motoașcă²,

Ungur

et al. 2021

Applied Sciences

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“…Only a few recent studies have investigated the effects of rehabilitation training on potential changes in the number and/or composition of muscle synergies and/or their activation profiles in stroke survivors [ 11 , 24 , 25 ]. Two small studies showed that EMG feedback could reduce co-activation between agonist and antagonist muscles during training in stroke participants [ 26 , 27 ]. While this finding aligns with our overall result, these studies did not assess the more global picture of arm intermuscular coordination.…”

Section: Discussionmentioning

confidence: 99%

Myoelectric interface training enables targeted reduction in abnormal muscle co-activation

Seo

Kishta

Mugler

et al. 2022

J NeuroEngineering Rehabil

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Background Abnormal patterns of muscle co-activation contribute to impaired movement after stroke. Previously, we developed a myoelectric computer interface (MyoCI) training paradigm to improve stroke-induced arm motor impairment by reducing the abnormal co-activation of arm muscle pairs. However, it is unclear to what extent the paradigm induced changes in the overall intermuscular coordination in the arm, as opposed to changing just the muscles trained with the MyoCI. This study examined the intermuscular coordination patterns of thirty-two stroke survivors who participated in 6 weeks of MyoCI training. Methods We used non-negative matrix factorization to identify the arm muscle synergies (coordinated patterns of muscle activity) during a reaching task before and after the training. We examined the extent to which synergies changed as the training reduced motor impairment. In addition, we introduced a new synergy analysis metric, disparity index (DI), to capture the changes in the individual muscle weights within a synergy. Results There was no consistent pattern of change in the number of synergies across the subjects after the training. The composition of muscle synergies, calculated using a traditional synergy similarity metric, also did not change after the training. However, the disparity of muscle weights within synergies increased after the training in the participants who responded to MyoCI training—that is, the specific muscles that the MyoCI was targeting became less correlated within a synergy. This trend was not observed in participants who did not respond to the training. Conclusions These findings suggest that MyoCI training reduced arm impairment by decoupling only the muscles trained while leaving other muscles relatively unaffected. This suggests that, even after injury, the nervous system is capable of motor learning on a highly fractionated level. It also suggests that MyoCI training can do what it was designed to do—enable stroke survivors to reduce abnormal co-activation in targeted muscles. Trial registration This study was registered at ClinicalTrials.gov (NCT03579992, Registered 09 July 2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03579992?term=NCT03579992&draw=2&rank=1)

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