The Influence of EMG-Triggered Robotic Movement on Walking, Muscle Force and Spasticity after an Ischemic Stroke

Abstract

Background and Objectives: Application of the EMG-driven robotic training in everyday therapeutic processes is a modern and innovative form of neurorehabilitation among patients after stroke. Active participation of the patient contributes to significantly higher activation of the sensorimotor network during active motor control rather than during passive movement. The study objective was to determine the effect of electromyographic triggering (EMG-triggered) robotic rehabilitation device treatment on walking, muscle force, and spasticity after an ischemic stroke. Materials and Methods: A total of 60 participants with impaired motor function and gait after subacute stroke were included in the study. Each patient was randomly assigned to an intervention or control group (IG or CG). All patients, except standard therapy, underwent 1 additional session of therapy per day, 5 days a week for 6 weeks. IG had 30 min of training on the robot, while CG received exercises on the lower limb rotor. The subjects were assessed with Timed Up and Go Test (TUG), Ashworth scale, knee range of motion (ROM), Lovett Scale, and tight circumference at baseline and at weeks 2, 4, and 6. Results: For seven parameters, the values credibly increased between consecutive measurements, and for the Ashworth scale, they credibly decreased. The biggest changes were observed for the measurements made with Lovett scale. The average thigh circumference as measured 5 and 15 cm above the knee increased credibly more in the robot condition, as compared to control condition. Additionally, the decrease in Ashworth values over time, although statistically credible in both groups, was credibly higher in the robot condition. Conclusion: The inclusion of the EMG-triggered neurorehabilitation robot in the patient’s daily rehabilitation plan has a positive effect on outcomes of the treatment. Both proposed rehabilitation protocols significantly improved patients’ condition regarding all measured outcomes, but the spasticity and thigh circumference improved significantly better in the robotic group in comparison to controls.

Improvements of mid‐thigh circumferences following robotic rehabilitation in hemiparetic stroke patients

“…These findings are in agreement with the findings from a previous study by Lewandowska‐Sroka et al. (2021), which examined the effect of conventional versus robotic physiotherapy on thigh circumferences in 60 subjects. In that study, 30 patients were scheduled to undergo five sessions of conventional physiotherapy per week for a duration of 6 weeks.…”

“…However, comparing only between the paretic limbs, the current study showed that the average means of mid-thigh circumferences after 4 weeks of therapy were significantly different between the CR and RR groups. These findings are in agreement with the findings from a previous study by Lewandowska-Sroka et al (2021), which examined the effect of conventional versus robotic physiotherapy on thigh circumferences in 60 subjects. In that study, 30 patients were scheduled to undergo five sessions of conventional physiotherapy per week for a duration of 6 weeks.…”

An Optimized Stimulation Control System for Upper Limb Exoskeleton Robot-Assisted Rehabilitation Using a Fuzzy Logic-Based Pain Detection Approach

“…Electromyography (EMG) signals have shown potential for detecting muscle state during robotic rehabilitation training in physical therapy. Indeed, rehabilitation robots equipped with reactive electromyography capture EMG signals from a patient’s muscles, allowing them to assist in the rehabilitation process [ 37 ]. Studies have investigated the use of EMG signals in robot-based stroke neurorehabilitation to improve functional outcomes for patients [ 38 ].…”

Application of robots controlled by EMG signals in physiotherapy and rehabilitation

“…Ispitanici koji su koristila terapiju bez treninga također su poboljšali motoriku i funkcionalnost (15). U istraživanju s ciljem određivanja učinka liječenja robotskom terapijom pokrenutom EMG signalom korišten je Luna EMG za terapiju gornjih i donjih udova (16). Luna EMG stroj otkriva namjere pokušaja pokreta pacijenta pomoću površinskih EMG signala te pomaže u aktivnostima donjih ekstremiteta, kao savijanje i ispravljanje koljena.…”