Quantitative EEG for Predicting Upper Limb Motor Recovery in Chronic Stroke Robot-Assisted Rehabilitation

Trujillo, Paula; Mastropietro, Alfonso; Scano, Alessandro; Chiavenna, Andrea; Mrakic‐Sposta, Simona; Caimmi, Marco; Molteni, Franco; Rizzo, Giovanna

doi:10.1109/tnsre.2017.2678161

Cited by 64 publications

(52 citation statements)

References 73 publications

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“…The previous considerations suggest that, in general, kinematics are strongly related to the patient status described by clinical scales, which could be an expected outcome since they measure similar parameters. Instead, EEG variables may be relevant not only for the evaluation of the status of the patients, but even as descriptors or predictors of the possible outcome of the therapy [52]. Moreover, muscle synergies show partial coherency with the kinematics, as observed also in previous works [21], and may reflect at muscle level the alterations found in cortical EEG-based parameters.…”

Section: Integrationmentioning

confidence: 72%

A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation

et al. 2018

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Multidomain instrumental evaluation of post-stroke chronic patients, coupled with standard clinical assessments, has rarely been exploited in the literature. Such an approach may be valuable to provide comprehensive insight regarding patients’ status, as well as orienting the rehabilitation therapies. Therefore, we propose a multidomain analysis including clinically compliant methods as electroencephalography (EEG), electromyography (EMG), kinematics, and clinical scales. The framework of upper-limb robot-assisted rehabilitation is selected as a challenging and promising scenario to test the multi-parameter evaluation, with the aim to assess whether and in which domains modifications may take place. Instrumental recordings and clinical scales were administered before and after a month of intensive robotic therapy of the impaired upper limb, on five post-stroke chronic hemiparetic patients. After therapy, all patients showed clinical improvement and presented pre/post modifications in one or several of the other domains as well. All patients performed the motor task in a smoother way; two of them appeared to change their muscle synergies activation strategies, and most subjects showed variations in their brain activity, both in the ipsi- and contralateral hemispheres. Changes highlighted by the new multiparametric instrumental approach suggest a recovery trend in agreement with clinical scales. In addition, by jointly demonstrating lateralization of brain activations, changes in muscle recruitment and the execution of smoother trajectories, the new approach may help distinguish between true functional recovery and the adoption of suboptimal compensatory strategies. In the light of these premises, the multi-domain approach may allow a finer patient characterization, providing a deeper insight into the mechanisms underlying the relearning procedure and the level (neuro/muscular) at which it occurred, at a relatively low expenditure. The role of this quantitative description in defining a personalized treatment strategy is of great interest and should be addressed in future studies.

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Section: Integrationmentioning

confidence: 72%

A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation

et al. 2018

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“…Some experiments have been conducted with EEG signals that show differences on potential recovery of chronic subjects. These results can be exploited to understand who needs further exercise therapy (Trujillo et al, 2017 ). Also the corticospinal tract status seemed to correlate with motor skill even in the chronic stage (Schaechter et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

Muscle Synergies-Based Characterization and Clustering of Poststroke Patients in Reaching Movements

Scano

Chiavenna

Malosio

et al. 2017

Front. Bioeng. Biotechnol.

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BackgroundA deep characterization of neurological patients is a crucial step for a detailed knowledge of the pathology and maximal exploitation and customization of the rehabilitation therapy. The muscle synergies analysis was designed to investigate how muscles coactivate and how their eliciting commands change in time during movement production. Few studies investigated the value of muscle synergies for the characterization of neurological patients before rehabilitation therapies. In this article, the synergy analysis was used to characterize a group of chronic poststroke hemiplegic patients.MethodsTwenty-two poststroke patients performed a session composed of a sequence of 3D reaching movements. They were assessed through an instrumental assessment, by recording kinematics and electromyography to extract muscle synergies and their activation commands. Patients’ motor synergies were grouped by the means of cluster analysis. Consistency and characterization of each cluster was assessed and clinically profiled by comparison with standard motor assessments.ResultsMotor synergies were successfully extracted on all 22 patients. Five basic clusters were identified as a trade-off between clustering precision and synthesis power, representing: healthy-like activations, two shoulder compensatory strategies, two elbow predominance patterns. Each cluster was provided with a deep characterization and correlation with clinical scales, range of motion, and smoothness.ConclusionThe clustering of muscle synergies enabled a pretherapy characterization of patients. Such technique may affect several aspects of the therapy: prediction of outcomes, evaluation of the treatments, customization of doses, and therapies.

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“…Millions of people worldwide are functionally affected by stroke [1,2] with almost 75% of cases occurring in low-to middle-income countries, leading to residual motor disabilities and the need for intensive rehabilitation and eventually, economic, and social burdens on the patient, caregiver and/or family and society [3,4].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial

et al. 2021

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Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function in stroke patients. The aim of the current study was to determine the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) acupoints on cortical activity and the motor function of the affected UE in chronic stroke patients. Forty male and female patients diagnosed with stroke agreed to join the study. They were randomly assigned to group 1 (G1) and group 2 (G2). G1 received task-specific training (TST) and sham electrical stimulation while G2 received TST in addition to TENS acupoints. Session duration was 80 min. Both groups received 18 sessions for 6 successive weeks, 3 sessions per week. Evaluation was carried out before and after completion of the treatment program. Outcome measures used were the Fugl-Meyer Assessment of the upper extremity (FMA-UE) and the box and block test (BBT) as measures of the motor function of the affected UE. Brain activity of the motor area (C3) in the ipsilesional hemisphere was measured using a quantitative electroencephalogram (QEEG). The measured parameter was peak frequency. It was noted that the motor function of the affected UE improved significantly post-treatment in both groups, while no significant change was reported in the FMA-UE and BBT scores post-treatment in either G1 or G2. On the other hand, the activity of the motor area C3 improved significantly in G2 only, post-treatment, while G1 showed no significant improvement. There was also significant improvement in the activity of the motor area (C3) in G2 compared to G1 post-treatment. The results of the current study indicate that TST only or combined with TENS acupoints can be considered an effective method for improving motor function of the affected UE in chronic stroke patients, both being equally effective. However, TST combined with TENS acupoints proved better in improving brain plasticity in chronic stroke patients.

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Quantitative EEG for Predicting Upper Limb Motor Recovery in Chronic Stroke Robot-Assisted Rehabilitation

Cited by 64 publications

References 73 publications

A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation

A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation

Muscle Synergies-Based Characterization and Clustering of Poststroke Patients in Reaching Movements

Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial

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