Electromyographic analysis of upper limb muscles during standardized isotonic and isokinetic robotic exercise of spastic elbow in patients with stroke

Sin, Minki; Kim, Won‐Seok; Park, Daegeun; Yu, Miao; Kim, Woo Jin; Cho, Kyu-Jin; Paik, Nam–Jong

doi:10.1016/j.jelekin.2013.10.002

Cited by 19 publications

(13 citation statements)

References 25 publications

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“…Accordingly, spasticity is considered to be an exceptional form of increased muscle tone [38]. Sin et al confirmed that the co-contraction of antagonist muscles is exaggerated and is related with spasticity during recovery on hemiplegic stroke patients [39]. Leonard et al revealed that increased co-contraction is observed in the hemiplegic limbs of stroke patients during functional movement, and that the CCR is positively correlated with modified Ashworth scores [32].…”

Section: Discussionmentioning

confidence: 99%

Co-Contraction of Lower Limb Muscles Contributes to Knee Stability During Stance Phase in Hemiplegic Stroke Patients

Yuan

et al. 2019

Med Sci Monit

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BackgroundKnee stability has an important role in the gait of hemiplegic stroke patients. However, factors affecting knee stability have not been assessed concerning gait. The purpose of this study was to explore whether co-contraction of the lower limb muscles contributes to the knee stability during the stance phase of the gait cycle in hemiplegic stroke patients.Material/MethodsA total of 30 hemiplegic stroke patients, ages 36–79 years, were instructed to walk at their natural speed. The root mean square of surface electromyography was used to measure activities of the biceps femoris and rectus femoris muscles, while the co-contraction ratio was computed based on the root mean squares. The peak angle of knee extension was acquired in the stance phase by 3D kinematic analyses. Lower limb function was evaluated using the Fugl-Meyer scale for lower limb motor assessment.ResultsA statistically significant increase of the muscle co-contraction ratio of the involved extremity was observed compared with that of the uninvolved extremity (t=−4.066, P<0.05). The muscle co-contraction ratio was significantly correlated with the peak angle of knee extension (r=0.387, P=0.035), Fugl-Meyer scale (r=−0.522, P=0.003), and Modified Ashworth Scale (r=0.404, P=0.027) during the stance phase of the gait cycle.ConclusionsOur results showed that co-contraction of the rectus femoris muscle contributes to the stability of the knee and lower limb function in hemiplegic stroke patients, and suggests that co-contraction should be considered in the rehabilitation of knee stability during gait in hemiplegic stroke patients. Appropriate rehabilitation assessment planning with hemiplegic stroke patients, such as muscle co-contraction or knee stability of, might be created based on our results.

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Section: Discussionmentioning

confidence: 99%

Co-Contraction of Lower Limb Muscles Contributes to Knee Stability During Stance Phase in Hemiplegic Stroke Patients

Yuan

et al. 2019

Med Sci Monit

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“…As the motor function is improved, movement with an external constraint such as force support or kinematic constraints including isokinetic conditions can be adopted for training. In particular, isokinetic movements have several advantages over other constraints-for example, they improve the capability to generate and control a force at a varying posture during movement, the training is safe because of the limited speed of end-point or a particular joint movement, and co-contraction of agonist and antagonist muscles during force generation is prevented (23). The extent of the constraint can be gradually reduced as the trainee recovers motor function.…”

Section: Consideration Of Task Conditions For Effective Rehabilitatiomentioning

confidence: 99%

“…Exercise at a controlled speed within the limited range of motion can prevent secondary muscle injury. In addition, we reported that isokinetic movement promotes the activation of agonist muscles without provoking co-contraction of antagonist muscles (23).…”

Section: Introductionmentioning

confidence: 99%

Alterations in intermuscular coordination underlying isokinetic exercise after a stroke and their implications on neurorehabilitation

Park

Shin

Lee

et al. 2020

Preprint

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Background: Abnormal intermuscular coordination limits the motor capability of stroke-affected upper limbs. By evaluating the intermuscular coordination in the affected limb under various biomechanical task constraints, the impact of a stroke on motor control can be analyzed and intermuscular coordination-based rehabilitation strategies can be developed. In this study, we investigated upper limb intermuscular coordination after a stroke during isokinetic movements. Methods: Sixteen chronic stroke survivors and eight neurologically intact individuals were recruited. End-point forces and electromyographic activities of the shoulder and elbow muscles were measured while the participants performed isokinetic upper limb movements in a three-dimensional space. Intermuscular coordination of the stroke survivors and the control participants was quantified in the form of muscle synergies. Then, we compared the number, composition, and activation coefficients of muscle synergies and the end-point force between the groups. The correlation between the alteration of muscle synergies and the level of motor impairment was investigated. Results: Four and five muscle synergies in the stroke and control groups were observed, respectively. The composition of muscle synergies was comparable between the groups, except that the three heads of the deltoid muscle were co-activated and formed one synergy in the stroke group, whereas those muscles formed two synergies in the control group. When the number of muscle synergies between the groups matched, the comparable composition of muscle synergies was observed in both groups. Alternatively, the modulation of synergy activation coefficients was altered after a stroke. The severity of motor impairments was negatively correlated with the similarity of the post-stroke synergies with respect to the mean control synergies. Conclusions: Stroke-affected upper limbs seemed to modularize the activation of the shoulder and elbow muscles in a fairly similar way to that of neurologically intact individuals during isokinetic movements. Compared with free (i.e., unconstrained) movement, exercise under biomechanical constraints including the isokinetic constraint might promote the activation of muscle synergies independently in stroke survivors. We postulated the effect of biomechanical constraints on the intermuscular coordination and suggested a possible intermuscular coordination-based rehabilitation protocol that provides the biomechanical constraint appropriate to a trainee throughout the progress of rehabilitation.

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“…Sensing EMG signals and analysing them to identify and differentiate between limb gesture has been a field of huge interest to many researchers for the past few decades [2] [3] [4] [5]. This is due to the various engineering and medical applications of systems which allow accurate gesture recognition [6] [7]. According to the World Health Organisation, there are 15 million strokes occurring each year.…”

Section: Introductionmentioning

confidence: 99%

A Robust, Practical Upper Limb Electromyography Interface Using Dry 3D Printed Electrodes

Abass

Meng

Xie

et al. 2019

2019 IEEE/ASME International Conference on Advanced Intelligent Mechatronics (AIM)

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This study aims to develop a practical, robust and reliable human-machine interface using gesture recognition based on surface electromyography (sEMG) signals from the forearm. This technology is developed to be employed medically in stroke rehabilitation or prosthetic control. So far, studies have been conducted that improved the accuracy of such systems, but little has been done to avoid using wet (gelled) electrodes and hence improve their reliability and robustness for long-term use. Through this study, a comfortable and wearable biosignal acquisition device is designed and developed that uses dry EMG electrodes. 3D printed electrodes are compared with ready-made dry ones to choose the better option, and an interface is established that allows control of any mechatronic system such as a prosthetic arm.

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Electromyographic analysis of upper limb muscles during standardized isotonic and isokinetic robotic exercise of spastic elbow in patients with stroke

Cited by 19 publications

References 25 publications

Co-Contraction of Lower Limb Muscles Contributes to Knee Stability During Stance Phase in Hemiplegic Stroke Patients

Co-Contraction of Lower Limb Muscles Contributes to Knee Stability During Stance Phase in Hemiplegic Stroke Patients

Alterations in intermuscular coordination underlying isokinetic exercise after a stroke and their implications on neurorehabilitation

A Robust, Practical Upper Limb Electromyography Interface Using Dry 3D Printed Electrodes

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