The Use of Wearable Sensors for the Movement Assessment on Muscle Contraction Sequences in Post-Stroke Patients during Sit-to-Stand

Abstract

Electromyography (EMG) sensors have been used to study the sequence of muscle contractions during sit-to-stand (STS) in post-stroke patients. However, the majority of the studies used wired sensors with a limited number of placements. Using the latest improved wearable technology with 16 sensors, the current study was a thorough investigation to evaluate the contraction sequences of eight key muscles on the trunk and bilateral limbs during STS in post-stroke patients, as it became feasible. Multiple wearable sensors for the detection of muscle contraction sequences showed that the post-stroke patients performed STS with abnormal firing sequences, not only in the primary mover on the sagittal plane during raising, but also in the tibialis anterior, which may affect anticipatory postural adjustment in the gluteus medius, which may affect balance control. The abnormal tibialis anterior contraction until the early ascending phase and the delayed firing of the gluteus muscles highlight the importance of whole-kinetic-chain monitoring of contraction sequences using wearable sensors. The findings can be helpful for the design of therapeutic exercises.

Analyzing Human Muscle State with Flexible Sensors

“…And EMG signals are measured to determine the electrical current generated by muscle contractions in neuromuscular activity [46]. Therefore, electromyography (EMG) is often used as a tool to determine muscle activity [47][48][49][50]. Bogey et al [44,51] recently developed a method to estimate force from EMG signals and based on normalization of activation during maximum voluntary contraction to record maximum muscle force.…”

“…Hashemi et al [55] combined angle-based EMG amplitude calibration and parallel cascade identification (PCI) modeling for EMGbased force estimation in dynamic contractions, including concentric and eccentric contractions of the biceps and triceps, in order to enhance dynamic EMG-force estimation. Hsu et al [47] used EMG sensors to study the sequence of muscle contractions in patients from sitting to standing (STS) after stroke. Kim et al [56] estimated the muscle strength of nine muscle groups of the lower limbs using a static optimization method with inverse dynamics based on motion data and compared it with EMG signals.…”

Application of Modern Multi-Sensor Holter in Diagnosis and Treatment

“…As interesting research study for the precise control of prosthetic devices, the surface potential mapping [113] or stretchable EMG patch sensor integrated with the miniaturized wireless system modules, should also be mentioned [90]. The capability of muscle activity Holters can grow rapidly when connected together in a synchronous network, demonstrated, for example, in the case of EMG Holters by Delsys Incorporated (MA, USA) in their Trigno platform or by BTS Bioengineering Corp. (MA, USA) in their FREEEMG series [108][109][110][111][112]. As interesting research study for the precise control of prosthetic devices, the surface potential mapping [113] or stretchable EMG patch sensor integrated with the miniaturized wireless system modules, should also be mentioned [90].…”

Gluteus Maximus Muscle Activation Characteristics During a Chair-Rise in Adults With Chronic Stroke

“…Temporal electromyographic (EMG) differences poststroke occur with delayed onset timings of paretic tibialis anterior, rectus femoris, and transverse abdominis with earlier soleus activations. [28][29][30][31][32] As a compensatory mechanism, the nonparetic extremity displays earlier and prolonged hamstring activation compared with the quadriceps. 29,30 A paucity of research investigating GM activation during chair-rising post-stroke has been noted with studies lacking reference to magnitude or interlimb assessment, 32 including interlimb activation without controls, 33 or measurement with varying foot positions.…”

“…[28][29][30][31][32] As a compensatory mechanism, the nonparetic extremity displays earlier and prolonged hamstring activation compared with the quadriceps. 29,30 A paucity of research investigating GM activation during chair-rising post-stroke has been noted with studies lacking reference to magnitude or interlimb assessment, 32 including interlimb activation without controls, 33 or measurement with varying foot positions. 34 Thus, GM activation research during a chair-rise comparing the chronic stroke population with healthy controls is needed to guide clinical recommendations on utilization and timing and to evaluate changes in interlimb muscle activation.…”