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Martinez-Peon D, Garcia-Hernandez NV, Benavides-Bravo FG, Parra-Vega V. Characterization and classification of kinesthetic motor imagery levels. J Neural Eng 2024; 21:046024. [PMID: 38963179 DOI: 10.1088/1741-2552/ad5f27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
Objective.Kinesthetic Motor Imagery (KMI) represents a robust brain paradigm intended for electroencephalography (EEG)-based commands in brain-computer interfaces (BCIs). However, ensuring high accuracy in multi-command execution remains challenging, with data from C3 and C4 electrodes reaching up to 92% accuracy. This paper aims to characterize and classify EEG-based KMI of multilevel muscle contraction without relying on primary motor cortex signals.Approach.A new method based on Hurst exponents is introduced to characterize EEG signals of multilevel KMI of muscle contraction from electrodes placed on the premotor, dorsolateral prefrontal, and inferior parietal cortices. EEG signals were recorded during a hand-grip task at four levels of muscle contraction (0%, 10%, 40%, and 70% of the maximal isometric voluntary contraction). The task was executed under two conditions: first, physically, to train subjects in achieving muscle contraction at each level, followed by mental imagery under the KMI paradigm for each contraction level. EMG signals were recorded in both conditions to correlate muscle contraction execution, whether correct or null accurately. Independent component analysis (ICA) maps EEG signals from the sensor to the source space for preprocessing. For characterization, three algorithms based on Hurst exponents were used: the original (HO), using partitions (HRS), and applying semivariogram (HV). Finally, seven classifiers were used: Bayes network (BN), naive Bayes (NB), support vector machine (SVM), random forest (RF), random tree (RT), multilayer perceptron (MP), and k-nearest neighbors (kNN).Main results.A combination of the three Hurst characterization algorithms produced the highest average accuracy of 96.42% from kNN, followed by MP (92.85%), SVM (92.85%), NB (91.07%), RF (91.07%), BN (91.07%), and RT (80.35%). of 96.42% for kNN.Significance.Results show the feasibility of KMI multilevel muscle contraction detection and, thus, the viability of non-binary EEG-based BCI applications without using signals from the motor cortex.
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Affiliation(s)
- D Martinez-Peon
- Department of Electrical and Electronic Engineering, National Technological Institute of Mexico (TecNM)- IT Nuevo Leon, Guadalupe, Mexico
| | - N V Garcia-Hernandez
- National Council on Science and Technology, Saltillo, Mexico
- Robotics and Advanced Manufacturing, Research Center for Advanced Studies (Cinvestav), Saltillo, Mexico
| | - F G Benavides-Bravo
- Department of Basic Sciences, National Technological Institute of Mexico (TecNM)- IT Nuevo Leon, Guadalupe, Mexico
| | - V Parra-Vega
- Robotics and Advanced Manufacturing, Research Center for Advanced Studies (Cinvestav), Saltillo, Mexico
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Qiu H, Li F, Zhang S, Xiao S, Liu H, Chen S, Li X, Fang K, Wen J, Li T. Surface electromyographic characteristics of forearm muscles after ulnar and radius fracture inchildren. Front Pediatr 2023; 11:1143047. [PMID: 37187580 PMCID: PMC10175601 DOI: 10.3389/fped.2023.1143047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Objective To evaluate the characteristics of forearm muscle activity in children with ulnar and radius fractures during different follow-up periods by surface electromyography. Methods A retrospective analysis was performed on 20 children with ulnar and radius fractures treated with an elastic intramedullary nail from October 2020 to December 2021. All children were treated with transcubital casts after surgery. At 2 months and before taking out the elastic intramedullary nail, surface electromyographic signals were collected on the flexor/extension of the wrist and the maximum arbitrary isometric contraction of the grip strength in the forearm flexor and extensor muscles of the forearm. The root-mean-square values and integrated EMG values of the superficial flexor and extensor digitalis of the healthy side and the affected side were collected at the last follow-up and 2 months after surgery, and the co-systolic ratio was calculated. The root-mean-square values and co-systolic ratio were compared and analyzed, and the Mayo wrist function score was evaluated. Results The mean follow-up time was (8.4 ± 2.85) months. Mayo scores were (87.42 ± 13.01) and (97.69 ± 4.50) points at the last follow-up and two months after surgery, respectively (p < 0.05). In the test of grip strength, 2 months after surgery, the grip strength of the affected side was lower than that of the healthy side (p < 0.05), and the maximum and mean values of the superficial flexor of the affected side were lower than those of the healthy side (p < 0.05). At the last follow-up, there was no difference in the grip strength between the affected side and the healthy side (p > 0.05), and no difference in the maximum RMS, mean RMS and cooperative contraction ratio of the superficial flexor and digital extensor muscles between the affected side and the healthy side (p > 0.05). Conclusion Satisfactory results can be obtained after elastic intramedullary napping in children with ulnar and radius fractures. However, 2 months after surgery, the grip strength of the affected side is small, and the electrical activity of the forearm muscle is low during flexion and extension activities of the wrist joint, which has not returned to normal, suggesting that children orthopaedic clinicians should remind children to conduct timely and effective rehabilitation training after the removal of the cast.
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Affiliation(s)
- Hailing Qiu
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Fanling Li
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Siqi Zhang
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Sheng Xiao
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Haobo Liu
- Department of Anesthesiology, The First People’s Hospital of Chenzhou, Chenzhou, China
| | - Shuangxi Chen
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Xin Li
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Ke Fang
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Jie Wen
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Department of Anatomy, Hunan Normal University School of Medicine, Changsha, China
- Correspondence: Jie Wen
| | - Tingzhi Li
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
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Liu K, Yin M, Cai Z. Research and application advances in rehabilitation assessment of stroke. J Zhejiang Univ Sci B 2022; 23:625-641. [PMID: 35953757 DOI: 10.1631/jzus.b2100999] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Stroke has a high incidence and disability rate, and rehabilitation is an effective means to reduce the disability rate of patients. To systematize rehabilitation assessment, which is the foundation for rehabilitation therapy, we summarize the assessment methods commonly used in research and clinical applications, including the various types of stroke rehabilitation scales and their applicability, and related biomedical detection technologies, including surface electromyography (sEMG), motion analysis systems, transcranial magnetic stimulation (TMS), magnetic resonance imaging (MRI), and combinations of different techniques. We also introduce some assessment techniques that are still in the experimental phase, such as the prospective application of artificial intelligence (AI) with optical correlation tomography (OCT) in stroke rehabilitation. This review provides a useful bibliography for the assessment of not only the severity of stroke injury, but also the therapeutic effects of stroke rehabilitation, and establishes a solid base for the future development of stroke rehabilitation skills.
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Affiliation(s)
- Kezhou Liu
- Department of Biomedical Engineering, School of Automation (Artificial Intelligence), Hangzhou Dianzi University, Hangzhou 310018, China.
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Hokazono A, Etoh S, Jonoshita Y, Kawahira K, Shimodozono M. Combination therapy with repetitive facilitative exercise program and botulinum toxin type A to improve motor function for the upper-limb spastic paresis in chronic stroke: A randomized controlled trial. J Hand Ther 2021; 35:507-515. [PMID: 33820711 DOI: 10.1016/j.jht.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN An open-label, randomized, controlled, observer-blinded trial. INTRODUCTION Repetitive facilitative exercise (RFE) is a movement therapy to recover from hemiparesis after stroke. However, improvement is inhibited by spasticity. Recently, botulinum toxin type A (BoNT-A) injection has been shown to reduce spasticity. PURPOSE To examine the combined effect of an RFE program and BoNT-A treatment on upper-limb spastic paresis in chronic stroke. METHODS Forty chronic stroke inpatients with upper-limb spastic paresis (Brunnstrom stage ≥III and Modified Ashworth Scale [MAS] score ≥1) were enrolled. Subjects were randomized into 2 groups of 20 each and received 4 weeks of treatment. The intervention group received RFE and BoNT-A injection; the control group underwent RFE only. Assessments were performed at baseline and at study conclusion. The primary outcome was change in Fugl-Meyer Assessment score for the upper extremity (FMA). The Action Research Arm Test (ARAT), active range of motion, Box and Block Test, and MAS were also evaluated. RESULTS All participants completed this study. After 4 weeks, the intervention group evidenced a significantly greater increase in FMA score (median 11.0 [range 4-20]) than the control group (median 3.0 [range 0-9]) (P < .01, r = 0.79); as well as improvements in the other measures such as ARAT (median 12.5 [range 4-22] vs 7 [0-13]) (P < .01, r = 0.6), and MAS in the elbow flexors (median -1.5 [range -2 to 0] vs -1 [-2 to 0]) (P < .01, r = 0.45). DISCUSSION A high degree of repetitive volitional movement induced by the facilitative technique with concomitant control of spasticity by BoNT-A injection might increase efficiency of motor learning with continuous movement of the affected upper-limb. CONCLUSIONS The combination of RFE and BoNT-A for spastic paresis might be more effective than RFE alone to improve upper-limb motor function and to lessen impairment in chronic stroke.
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Affiliation(s)
- Akihiko Hokazono
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Seiji Etoh
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuiko Jonoshita
- Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan
| | - Kazumi Kawahira
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Megumi Shimodozono
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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Dalton EJ, Churilov L, Lannin NA, Corbett D, Campbell BCV, Hayward KS. Early-phase dose articulation trials are underutilized for post-stroke motor recovery: A systematic scoping review. Ann Phys Rehabil Med 2021; 65:101487. [PMID: 33429089 DOI: 10.1016/j.rehab.2021.101487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To enable development of effective interventions, there is a need to complete systematic early-phase dose articulation research. This scoping review aimed to synthesize dose articulation research of behavioral motor interventions for stroke recovery. METHODS MEDLINE and EMBASE were systematically searched for dose articulation studies. Preclinical experiments and adult clinical trials were classified based on the discovery pipeline and analyzed to determine which dose dimensions were articulated (time, scheduling or intensity) and how they were investigated (unidimensional vs multidimensional approach). Reporting of dose, safety and efficacy outcomes were summarized. The intervention description, risk of bias, and quality was appraised. RESULTS We included 41 studies: 3 of preclinical dose preparation (93 rodents), 2 Phase I dose ranging (21 participants), 9 Phase IIA dose screening (198 participants), and 27 Phase IIB dose finding (1879 participants). All studies adopted a unidimensional approach. Time was the most frequent dimension investigated (53%), followed by intensity (29%), and scheduling (18%). Overall, 95% studies reported an efficacy outcome; however, only 65% reported dose and 45% reported safety. Across studies, 61% were at high risk of bias, and the average percentage reporting of intervention description and quality was 61% and 67%, respectively. CONCLUSION This review highlights a need to undertake more high-quality, early-phase studies that systematically articulate intervention doses from a multidimensional perspective in the field of behavioral motor stroke recovery. To address this gap, we need to invest in adapting early phase trial designs, especially Phase I, to support multidimensional dose articulation.
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Affiliation(s)
- Emily J Dalton
- Melbourne School of Health Sciences, University of Melbourne, Heidelberg, Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Natasha A Lannin
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia
| | - Dale Corbett
- Cellular & Molecular Medicine and Canadian Partnership for Stroke Recovery, University of Ottawa, Canada
| | - Bruce C V Campbell
- Department of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Kathryn S Hayward
- Melbourne School of Health Sciences and Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, 3084 Heidelberg, Australia.
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Lee HC, Kuo FL, Lin YN, Liou TH, Lin JC, Huang SW. Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study. Am J Occup Ther 2021; 75:7501205020p1-7501205020p11. [PMID: 33399050 DOI: 10.5014/ajot.2021.038232] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE The effects of robot-assisted task-oriented training with tangible objects among patients with stroke remain unknown. OBJECTIVE To investigate the effects of robot-assisted therapy (RT) with a Gloreha device on sensorimotor and hand function and ability to perform activities of daily living (ADLs) among patients with stroke. DESIGN Randomized, crossover-controlled, assessor-blinded study. SETTING Rehabilitation clinic. PARTICIPANTS Patients (N = 24) with moderate motor and sensory deficits. INTERVENTION Patients participated in 12 RT sessions and 12 conventional therapy (CT) sessions, with order counterbalanced, for 6 wk, with a 1-mo washout period. OUTCOMES AND MEASURES Performance was assessed four times: before and after RT and before and after CT. Outcomes were measured using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Box and Block Test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, and a grip dynamometer for motor function; Semmes-Weinstein hand monofilament and the Revised Nottingham Sensory Assessment for sensory function; and the Modified Barthel Index (MBI) for ADL ability. RESULTS RT resulted in significantly improved FMA-UE proximal (p = .038) and total (p = .046) and MBI (p = .030) scores. Participants' EDC muscles exhibited higher efficacy during the small-block grasping task of the Box and Block Test after RT than after CT (p = .050). CONCLUSIONS AND RELEVANCE RT with the Gloreha device can facilitate whole-limb function, leading to beneficial effects on arm motor function, EDC muscle recruitment efficacy, and ADL ability for people with subacute and chronic stroke. WHAT THIS ARTICLE ADDS The evidence suggests that a task-oriented approach combined with the Gloreha device can facilitate engagement in whole-limb active movement and efficiently promote functional recovery.
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Affiliation(s)
- Hsin-Chieh Lee
- Hsin-Chieh Lee, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Fen-Ling Kuo
- Fen-Ling Kuo, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yen-Nung Lin
- Yen-Nung Lin, MD, MS, is Physiatrist, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, and Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei City, Taiwan
| | - Tsan-Hon Liou
- Tsan-Hon Liou, MD, PhD, is Physiatrist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jui-Chi Lin
- Jui-Chi Lin, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;
| | - Shih-Wei Huang
- Shih-Wei Huang, MD, is Physiatrist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Park JS, Lee G, Choi JB, Hwang NK, Jung YJ. Game-based hand resistance exercise versus traditional manual hand exercises for improving hand strength, motor function, and compliance in stroke patients: A multi-center randomized controlled study. NeuroRehabilitation 2020; 45:221-227. [PMID: 31498145 DOI: 10.3233/nre-192829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Game-based exercise is effective for improving strength and motor function in stroke patients undergoing rehabilitation, and it creates fun and motivation for exercise. OBJECTIVE We investigated the effect of game-based exercise on hand strength, motor function, and compliance in stroke patients. METHODS Fifty stroke patients were randomly divided into experimental and control groups. The experimental group performed a game-based hand resistance exercise. This exercise was divided into isotonic and isometric types and was performed 30 min/day, 5 days/week, for 6 weeks with 70% of the 1-repetition maximum. In contrast, the control group was given a traditional manual exercise by the occupational therapist, and the type of exercise and time involved were the same as those in the experimental group. The primary outcome measure was hand strength test measured using a dynamometer. Secondary outcome measures were manual function tests (MFT) and hand function tests using box and block test (BBT). Subject-based reports of motivation, fun, pain/fatigue evaluated on 0 to 10 numeric rating scales were compared between groups. RESULTS After training, hand strength, MFT and BBT was improved in the experimental group compared to the control group (P < 0.001, both). Subject-based reports of motivation and fun was significantly greater in the experimental group than the control group (P < 0.001, both), except to pain/fatigue (P = 0.728). CONCLUSIONS In conclusion, we demonstrated that game-based exercise is more effective than manual exercise in improving muscle strength, motor function, and compliance in stroke patients.
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Affiliation(s)
- Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan, South Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong-Bae Choi
- Department of Occupational Therapy, Kyunghee Medical Center, Seoul, South Korea
| | - Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul, Republic of Korea
| | - Young-Jin Jung
- Department of Radiological Science at Health Sciences Division, DongSeo University, Busan, South Korea
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Kuo FL, Lee HC, Hsiao HY, Lin JC. Robotic-assisted hand therapy for improvement of hand function in children with cerebral palsy: a case series study. Eur J Phys Rehabil Med 2020; 56:237-242. [PMID: 31939267 DOI: 10.23736/s1973-9087.20.05926-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Most types of robot-assisted training (RT) have been used in Cerebral Palsy (CP) patients only focus on proximal upper extremity. Few of study investigated the effect of distal upper extremity training. CASE REPORT Pediatric CP patients (N.=7) participated the RT sessions for 6 weeks (12 60-min sessions 2 times a week). Performance was assessed at 3 time points (pretest, posttest, and 1-month follow-up). RT significantly improved in body structure and function domains: FMA-UE scores (P=0.002). On electromyography, significant improvements in the mean brachioradialis muscle amplitude (P=0.015) and electrical agonist-antagonist muscle ratio (P=0.041) in the 1-inch cube-grasping task. The effects were maintained after 1 month. CLINICAL REHABILITATION IMPACT RT using a Gloreha device which focuses on the distal part of the upper limb benefit on body structure and function, including upper-extremity motor function, brachioradialis muscle recruitment, and coordination in children with cerebral palsy.
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Affiliation(s)
- Fen-Ling Kuo
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chieh Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Han-Yun Hsiao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jui-Chi Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan -
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Jarque-Bou NJ, Vergara M, Sancho-Bru JL, Roda-Sales A, Gracia-Ibáñez V. Identification of forearm skin zones with similar muscle activation patterns during activities of daily living. J Neuroeng Rehabil 2018; 15:91. [PMID: 30373606 PMCID: PMC6206932 DOI: 10.1186/s12984-018-0437-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/15/2018] [Indexed: 12/20/2022] Open
Abstract
Background A deeper knowledge of the activity of the forearm muscles during activities of daily living (ADL) could help to better understand the role of those muscles and allow clinicians to treat motor dysfunctions more effectively and thus improve patients’ ability to perform activities of daily living. Methods In this work, we recorded sEMG activity from 30 spots distributed over the skin of the whole forearm of six subjects during the performance of 21 representative simulated ADL from the Sollerman Hand Function Test. Functional principal component analysis and hierarchical cluster analysis (HCA) were used to identify forearm spots with similar muscle activation patterns. Results The best classification of spots with similar activity in simulated ADL consisted in seven muscular-anatomically coherent groups: (1) wrist flexion and ulnar deviation; (2) wrist flexion and radial deviation; (3) digit flexion; (4) thumb extension and abduction/adduction; (5) finger extension; (6) wrist extension and ulnar deviation; and (7) wrist extension and radial deviation. Conclusion The number of sEMG sensors could be reduced from 30 to 7 without losing any relevant information, using them as representative spots of the muscular activity of the forearm in simulated ADL. This may help to assess muscle function in rehabilitation while also simplifying the complexity of prosthesis control.
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Affiliation(s)
- Néstor J Jarque-Bou
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Avinguda Vicent Sos Baynat, s/n., 12071, Castellón, Spain.
| | - Margarita Vergara
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Avinguda Vicent Sos Baynat, s/n., 12071, Castellón, Spain
| | - Joaquín L Sancho-Bru
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Avinguda Vicent Sos Baynat, s/n., 12071, Castellón, Spain
| | - Alba Roda-Sales
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Avinguda Vicent Sos Baynat, s/n., 12071, Castellón, Spain
| | - Verónica Gracia-Ibáñez
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Avinguda Vicent Sos Baynat, s/n., 12071, Castellón, Spain
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Vinstrup J, Madeleine P, Jakobsen MD, Jay K, Andersen LL. Patient Transfers and Risk of Back Injury: Protocol for a Prospective Cohort Study With Technical Measurements of Exposure. JMIR Res Protoc 2017; 6:e212. [PMID: 29117932 PMCID: PMC5700406 DOI: 10.2196/resprot.8390] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 11/13/2022] Open
Abstract
Background More than one third of nurses experience musculoskeletal pain several times during a normal work week. Consistent use of assistive devices during patient transfers is associated with a lower risk of occupational back injuries and low back pain (LBP). While uncertainties exist regarding which type of assistive devices most efficiently prevent LBP, exposure assessments using technological advancements allow for quantification of muscle load and body positions during common work tasks. Objective The main objectives of this study are (1) to quantify low back and neck/shoulder muscle load in Danish nurses during patient transfers performed with different types of assistive devices, and (2) to combine the exposure profile for each type of assistive device with fortnightly questionnaires to identify the importance of muscle load (intensity and frequency of transfers) and body position (degree of back inclination and frequency) on LBP intensity and risk of back injury during a patient transfer. Methods A combination of technical measurements (n=50) and a prospective study design (n=2000) will be applied on a cohort of female nurses in Danish hospitals. The technical measurements will be comprised of surface electromyography and accelerometers, with the aim of quantifying muscle load and body positions during various patient transfers, including different types of assistive devices throughout a workday. The study will thereby gather measurements during real-life working conditions. The prospective cohort study will consist of questionnaires at baseline and 1-year follow-up, as well as follow-up via email every other week for one year on questions regarding the frequency of patient transfers, use of assistive devices, intensity of LBP, and back injuries related to patient transfers. The objective measurements on muscle load and body positions during patient handlings will be applied to the fortnightly replies regarding frequency of patient transfer and use of different assistive devices, in order to identify risk factors for back injuries related to patient transfers and intensity of LBP. Results Data collection is scheduled to commence during the winter of 2017. Conclusions The design of this study is novel in its combination of technical measurements applied on a prospective cohort, and the results will provide important information about which assistive devices are associated with intensity of LBP and risk of back injury related to patient transfers. Furthermore, this study will shed light on the dose-response relationship between intensity, duration, and frequency of patient transfers and the intensity of LPB in Danish nurses, and will thereby help to guide and improve electronic health practices among this population.
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Affiliation(s)
- Jonas Vinstrup
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance Group, SMI, Aalborg University, Aalborg, Denmark
| | - Pascal Madeleine
- Department of Health Science and Technology, Physical Activity and Human Performance Group, SMI, Aalborg University, Aalborg, Denmark
| | - Markus Due Jakobsen
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kenneth Jay
- The Carrick Institute for Graduate Studies, Institute of Clinical Neuroscience and Rehabilitation, Florida, FL, United States
| | - Lars Louis Andersen
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance Group, SMI, Aalborg University, Aalborg, Denmark
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