Influence of gravity compensation on muscle activity during reach and retrieval in healthy elderly

Prange, Grada Berendina; Kallenberg, L.A.C.; Jannink, M.J.A.; Stienen, Arno H. A.; Kooij, Herman van der; IJzerman, Maarten J.; Hermens, Hermie

doi:10.1016/j.jelekin.2007.08.001

Cited by 55 publications

(90 citation statements)

References 25 publications

(35 reference statements)

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“…The results confirmed our presumption based on previous studies with nondisabled elderly [10] and stroke patients [11,13,15] that also showed a decreased sEMG in antigravity muscles and unaffected timing. Remarkably, despite subjects with an MRC score of 0 in the triceps, sEMG activity was seen mainly during elbow flexion.…”

Section: Tasksupporting

confidence: 92%

“…In these robotic devices, different treatment modalities have been implemented, such as passive, active-assisted, and active-resisted movements [8]; consequently, gravity compensation is incorporated in the design [8][9]. Until now, the effect of gravity compensation on motor control and functional abilities has mainly been investigated in nondisabled elderly [10] and stroke patients [11][12][13][14][15]. Although many applications in rehabilitation after a spinal cord injury include gravity compensation during ADLs or exercise therapy, the specific effects on kinematics and muscle activation characteristics (amplitude and timing) in patients with a CSCI are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

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Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: An explorative study

Kloosterman¹,

Snoek²,

Kouwenhoven³

et al. 2010

JRRD

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Abstract-Many interventions in upper-limb rehabilitation after cervical spinal cord injury (CSCI) use arm support (gravity compensation); however, its specific effects on kinematics and muscle activation characteristics in subjects with a CSCI are largely unknown. We conducted a cross-sectional explorative study to study these effects. Nine subjects with a CSCI performed two goal-directed arm movements (maximal reach, reach and retrieval) with and without gravity compensation. Angles at elbow and shoulder joints and muscle activation were measured and compared. Seven subjects reduced elbow extension (range 1.8°-4.5°) during the maximal reaching task with gravity compensation. In the reach and retrieval task with gravity compensation, all subjects decreased elbow extension (range 0.1°-11.0°). Eight subjects executed movement closer to the body. Regarding muscle activation, gravity compensation did not influence timing; however, the amplitude of activation decreased, especially in antigravity muscles, namely mean change +/-standard deviation of descending part of trapezius (18.2% +/-37.5%), anterior part of deltoid (37.7% +/-16.7%), posterior part of deltoid (32.0% +/-13.9%), and long head biceps (49.6% +/-20.0%). Clinical implications for the use of gravity compensation in rehabilitation (during activities of daily living or exercise therapy) should be further investigated with a larger population.

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Section: Tasksupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: An explorative study

Kloosterman¹,

Snoek²,

Kouwenhoven³

et al. 2010

JRRD

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“…Recent training studies using weight support as a stand-alone therapeutic means show it to be effective in improving motor control [180,85,46], or have similar results compared to full robot-mediated training [4]. With the device detailed in this publication, we found muscle activity to decrease during short point-to-point movements with weight support, in cross-sectional experiments with both healthy elderly [163] and stroke patients [92], with the muscles maintaining arm posture against gravity alleviated the most.…”

Section: Introductionmentioning

confidence: 57%

“…As the Freebal is mostly made from aluminum, is painted black and hardly obstructs the view on the arm, both optical as magnetic based tracking systems can be used. In other studies, the Freebal was used with both visual tracking and EMG recording [163,164,92]. The Freebal can also be used to support the arm during interaction with virtual environments or playing games [165].…”

Section: Discussionmentioning

confidence: 99%

“…This weight support assists patients in making movements. For healthy humans, arm movements require two components of muscle activition; one 'phasic', steering the movement, the other, 'tonic', counteracting gravity [57,163]. By reducing the latter without distorting the former [92], patients can perform more and more meaningful exercises earlier in the rehabilitation process.…”

Section: Introductionmentioning

confidence: 99%

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Development of novel devices for upper-extremity rehabilitation

Stienen¹

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S U M M A R YThe goal of this dissertation was to improve rehabilitation robots by developing new patient-friendly devices which can assist therapists in the rehabilitation of neurological movement disorders of the upper extremities, such as hemiparetic stroke. In all, three novel rehabilitation devices were developed. Given the changing demographics of developed nations, over the next two decades fewer therapists will be available to treat an increasing number of stroke patients. With patient-friendly robots assisting therapists, proven therapeutic exercises can be automated and new and better targeted interventions developed and tested. In addition to facilitating therapy sessions, robots can provide objective measurement of impairment. Overall, robots can make therapy more productive for patients and less labor-intensive for therapists, and provide physicians, therapists and the scientific community with more objective data.To handle the wide range of impairments found in hemiparetic stroke patients, multiple devices are needed. Mildly impaired patients may have a near-normal range of motion, but have problems with fine motor control or moving heavier objects. Severely affected patients may not be able to even lift the weight of their own arm. Despite these differences, certain general strategies appear to work best. First and foremost, rehabilitation therapy works best when the patient is actively and intensively involved. Exercises should use repetitive movements that closely resemble those used in daily living for best results in reshaping the recovering brain.Studying motor learning in healthy subjects supported the need for active patient involvement. Given the artificial motor relearning task of moving in a visuomotor-rotated field, the healthy subject fully adapted when he could freely make, and correct, errors in their movement execution. On the other hand, active delivery of a passive hand to the targets resulted in much less and much slower adaptation. In between lay the adaptation achieved with hard and soft guidance of the hand over virtual tracks. The conclusion is that both minimization of execution errors and control effort drive kinematical adaptation in a novel visuomotor task, but the latter occurs at a much slower rate.Should the patient not be assisted at all? Perhaps the type of assistance is important. For instance, weight support of the arm facilitates movement, but movement initialization and control are left unchanged. Most rehabilitation devices for upper extremities include some form of weight support. An analysis of these devices concluded that weight support is most easily realized through a cablesuspension system that supports the arm via slings. However, the best possible solution for weight support depends on the primary design of the device. Careful upfront consideration of various design options will lead to better choices.The first rehabilitation device was designed using this knowledge. The Freebal is a dedicated weight-support system that is less complex and has less movem...

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Aspects of Weight-Support Mechanisms in Rehabilitation Robotics

Stienen¹,

Hekman²,

Kooij³

et al. 2009

IFMBE Proceedings

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Weight support can facilitate upper-limb movements, with which the patients may do more and more meaningful exercises earlier in the rehabilitation process. Most rehabilitation devices support the arm against gravity in one way or the other. Weight support can be realized by limiting vertical displacement or applying constant supportive forces which counteract the gravitational pull. Of these, using constant supportive forces is the most natural way to facilitate natural arm movements as it allows full freedom of movement and the amount of weight support is scalable to the patients needs. To apply the supporting forces to the arm, endpoint mechanisms and exoskeletons are more complex to build and use then cable suspensions, but offer more control over the movements. Finally, passive weight support is inherently safe, but active systems have enhanced control options and the capability to create training conditions beyond limb weight.

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Influence of gravity compensation on muscle activity during reach and retrieval in healthy elderly

Cited by 55 publications

References 25 publications

Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: An explorative study

Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: An explorative study

Development of novel devices for upper-extremity rehabilitation

Aspects of Weight-Support Mechanisms in Rehabilitation Robotics

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