Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Development of EMG-Triggered Functional Electrical Stimulation Device for Upper Extremity Bilateral Movement Training in Stroke Patients: Feasibility and Pilot study

  • Song, Changho (Department of Physical Therapy, College of Health and Welfare, Sahmyook University) ;
  • Seo, Dong-kwon (Department of Physical Therapy, College of Medical Science, Konyang University)
  • Received : 2021.09.21
  • Accepted : 2021.09.28
  • Published : 2021.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

Keywords

Acknowledgement

이 성과는 2019년도 정부(미래창조과학부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임 (No. 2018R1C1B5086043).

References

  1. Broeks JG, Lankhorst GJ, Rumping K, Prevo AJ. The long-term outcome of arm function after stroke: results of a follow-up study. Disabil Rehabil. 1999;21:357-64. https://doi.org/10.1080/096382899297459
  2. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation. 2021;143:e254-e743.
  3. Mukherjee D, Cg P. Epidemiology andthe global burden of stroke. World neurosurgery. 2011;76:S85-90. https://doi.org/10.1016/j.wneu.2011.07.023
  4. Jorgensen HS, Nakayama H, Raaschou Ho V-LJ, Stoier M, Ts O. Outcome and time course of recovery instroke. Part I: Outcome. 1995;76:399-405.
  5. Kwakkel G, Kollen BJ, Hi K. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabilitation and neural repair. 2008;22:111-21. https://doi.org/10.1177/1545968307305457
  6. Whitall J, McCombe Waller S, Silver Kh MRF. Repetitive bilateral arm training with rhythmic auditory cueingimproves motor function in chronic hemiparetic stroke. Stroke. 2000;31:2390-5. https://doi.org/10.1161/01.STR.31.10.2390
  7. Chan MK, Tong RK, Ky C. Bilateral upper limb training with functional electric stimulation in patients withchronic stroke. Neurorehabilitation and neural repair. 2009;23:357-65. https://doi.org/10.1177/1545968308326428
  8. Knutson JS, Harley MY, Hisel TZ, HoganSd MMM, Chae J. Contralaterally controlled functional electricalstimulation for upper extremity hemiplegia: an early-phase randomized clinicaltrial in subacute stroke patients. Neurorehabilitation and neural repair. 2012;3:239-46.
  9. Oujamaa L, Relave I, Froger J, Mottet D PJY. Rehabilitation of arm function after stroke. Literature review. nnals of physical and rehabilitation medicine. 2009;52:269-93. https://doi.org/10.1016/j.rehab.2008.10.003
  10. Mays R, McIntyre A, Kwok CTR. Bilateral arm training in the chronic phase of stroke rehabilitation: a systematic review and meta-analysis. Dalhousie Medical Journal. 2014;41:1-.
  11. Stewart KC, Cauraugh JH, Jj S. Bilateral movement training and stroke rehabilitation: a systematic review and meta-analysis. Journal of the neurological sciences. 2006;244:89-95. https://doi.org/10.1016/j.jns.2006.01.005
  12. Cauraugh JH, Jj S. Neuralplasticity and bilateral movements: A rehabilitation approach for chronicstroke. Progress in neurobiology. 2005;75:309-20. https://doi.org/10.1016/j.pneurobio.2005.04.001
  13. Trombly CA. Deficits of reaching in subjects with left hemiparesis: a pilot study. American Journal of Occupational Therapy. 1992;46:887-97. https://doi.org/10.5014/ajot.46.10.887
  14. Popovic MD, Kostic MD, Rodic SZ, Konstantinovic LM. Feedback-mediated upper extremities exercise: increasing patient motivation in poststroke rehabilitation. BioMed research international. 2014;2014.
  15. Arya KN, Pandian S, Kumar D, Puri V. Task-Based Mirror Therapy Augmenting Motor Recovery in Poststroke Hemiparesis:A Randomized Controlled Trial. Journal of stroke and cerebrovascular diseases :the official journal of National Stroke Association. 2015;24:1738-48. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.026
  16. Cauraugh JH, Kim S. Two coupled motorrecovery protocols are better than one: electromyogram-triggered neuromuscularstimulation and bilateral movements. Stroke. 2002;33:1589-94. https://doi.org/10.1161/01.str.0000016926.77114.a6
  17. Cauraugh J, Light K, Kim S, Thigpen M BA. Chronic motor dysfunction after stroke: recovering wrist and fingerextension by electromyography-triggered neuromuscular stimulation. Stroke. 2000;6:1360-4. https://doi.org/10.1161/01.STR.31.6.1360
  18. Kojima K, Ikuno K, Morii Y, Tokuhisa K, Morimoto S, Shomoto K. Feasibility study of a combined treatment of electromyography-triggered neuromuscular stimulation and mirror therapy in stroke patients: a randomized crossover trial. NeuroRehabilitation. 2014;34:235-44. https://doi.org/10.3233/nre-131038
  19. Ward NS, Cohen LG. Mechanisms underlying recovery of motor function after stroke. Archives of neurology. 2004;61:1844-8. https://doi.org/10.1001/archneur.61.12.1844
  20. Murase N, Duque J, Mazzocchio R, Cohen LG. Influence of interhemispheric interactions on motor function in chronic stroke. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 2004;55:400-9. https://doi.org/10.1002/ana.10848
  21. Renner CI, Brendel C, Hummelsheim H. Bilateral Arm Training vs Unilateral Arm Training for severely affected patients with stroke: exploratory single-blinded randomized controlled trial. Archives of physical medicine and rehabilitation. 2020;101:1120-30. https://doi.org/10.1016/j.apmr.2020.02.007
  22. G. BROEKS J, Lankhorst G, Rumping K, Prevo A. The long-term outcome of arm function after stroke: results of a follow-up study. Disability and rehabilitation. 1999;21:357-64. https://doi.org/10.1080/096382899297459